AccountId: 011433970860
ContactId: c8267861-bff2-41bd-af17-36cee29903f6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 154419 ms
Total Talk Time (AGENT): 87100 ms
Total Talk Time (CUSTOMER): 45240 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/c8267861-bff2-41bd-af17-36cee29903f6_20250418T13:24_UTC.wav
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[AGENT][NEUTRAL] Contacting APO. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling about um
[CUSTOMER][NEUTRAL] Uh, data service that wasn't paid for and I was just calling to get the explanation for that.
[AGENT][POSITIVE] Yes, of course, I can certainly help with that. What is your policy number, please, [PII]?
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] It might begin with a 01.
[CUSTOMER][NEUTRAL] Is that the payer ID?
[AGENT][NEUTRAL] No, it might begin with a 01 or 02. Um, did you receive an, yeah.
[CUSTOMER][NEUTRAL] Oh OK um.
[CUSTOMER][NEUTRAL] It's 02465404 ML7.
[AGENT][NEUTRAL] Thank you. And your uh date of birth and a phone number, please, sir?
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] [PII], phone number is [PII].
[AGENT][POSITIVE] Thank you very much. And what is that data service that we're looking for, please?
[CUSTOMER][NEUTRAL] Uh, it is for [PII].
[AGENT][NEUTRAL] OK. Now, is this treatment within a physician's office? Is that what we?
[AGENT][NEUTRAL] Um, looks like an office.
[CUSTOMER][NEUTRAL] An X-ray was taken, yeah.
[AGENT][NEUTRAL] OK, let's see what we have here. OK.
[AGENT][NEUTRAL] OK. Um, so what are your benefits, uh, with this are, um, this is for in and out of hospital settings only. Um, so the treatment within the physician's office, the offices that co-pay the, the X-ray in the hos in the doctor's office isn't gonna be covered because this is strictly for outpatient hospital services, the ER, urgent care, um,
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] That sort of thing. That's, that is what this will be.
[CUSTOMER][NEUTRAL] Is it, is it not for inpatient hospital stays either?
[AGENT][NEUTRAL] Yes, yes, it is for inpatient hospital stays. Now this was billed as outpatient, um, so, uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is this
[CUSTOMER][NEUTRAL] Yeah, it was done at an orthopedics office.
[AGENT][NEUTRAL] OK, so it was outpatient. OK, is it, it was in the physician's office, is that correct? OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, all right. Uh, yes, those, those places of service are not um covered.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, with this policy, and that's why that didn't, that wasn't covered.
[AGENT][NEUTRAL] So it would only be within a within a hospital setting.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK great thank you.
[AGENT][POSITIVE] OK, there's nothing else I can help with and thank you for contacting APL. Hope you have a very good day. Thank you, sir.