AccountId: 011433970860
ContactId: cd059b6c-505e-4b24-a07f-587bdd2ac7a6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 169339 ms
Total Talk Time (AGENT): 78265 ms
Total Talk Time (CUSTOMER): 38722 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/cd059b6c-505e-4b24-a07f-587bdd2ac7a6_20250122T14:08_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Good morning, um, I wanted to know the benefits for one of our patients.
[AGENT][NEUTRAL] OK, your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], what type of service is it in doctor's office or outpatient facility or dental?
[CUSTOMER][NEUTRAL] A doctor's office.
[AGENT][NEUTRAL] OK, and the policy number and a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] So the phone number is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And what else did you need?
[AGENT][NEUTRAL] Policy number
[CUSTOMER][NEUTRAL] For the patient?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 186-8817
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the patient's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] [PII] and [PII].
[AGENT][NEUTRAL] OK, thank you for that and so we're checking eligibility and then office visit benefit is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, so the policy effective date is [PII]. Policy is active at this time.
[AGENT][NEUTRAL] The office visit or the physician's visit fee is not covered. Uh, this policy does have a treatment rider. Uh, so if there's covered treatment during the course of the visit, those items can be considered under the outpatient benefit. Would you like that information?
[CUSTOMER][NEUTRAL] Um, do you have the information for copay for PCP?
[AGENT][NEUTRAL] So is it for the physician's visit or will there be treatment in the office?
[CUSTOMER][NEUTRAL] Uh, for the visit.
[AGENT][NEUTRAL] OK, so that is not covered. The office is a co-pay is not covered by this policy?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] Yes, um, for X-rays and ultrasounds. Does she have a copy here in the office?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK, so that would be considered treatment and those items can be considered under the outpatient benefit which is up to $2550 per calendar year and of course the information provided is verification, not a guarantee of payment and currently I'm not showing any of that benefit used this year for this year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] Um, no, ma'am.
[AGENT][POSITIVE] All righty. Well, thank you for calling APL [PII]. Have a good day.
[CUSTOMER][NEUTRAL] Likewise. Bye-bye.
[AGENT][NEUTRAL] Uh bye bye.