AccountId: 011433970860
ContactId: cf27954c-d11f-450e-8fbc-708fb3da6a34
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221309 ms
Total Talk Time (AGENT): 90158 ms
Total Talk Time (CUSTOMER): 63886 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/cf27954c-d11f-450e-8fbc-708fb3da6a34_20250224T17:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII], this is [PII]. I'm with uh Genesis Medical Group, and I'm calling to get benefits please.
[AGENT][POSITIVE] All right, [PII]. Happy to check benefits. What's the policy number?
[CUSTOMER][NEUTRAL] It is 02558162.
[AGENT][POSITIVE] Alright, thank you so much. Let me pull this up here.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], uh, date of birth is [PII].
[AGENT][NEUTRAL] Thank you. So, policy is active. The effective date on here is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Are we looking for like outpatient benefits or?
[CUSTOMER][NEUTRAL] Uh, it's gonna be for an office visit for a PCP and a specialist, and if I, if, if I can also get benefits for an annual physical.
[AGENT][NEUTRAL] OK, let me see what the policy covers here.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right. So it looks like patient has what we call limited benefit hospital indemnity plans. So outpatient office physician visits, they're allowed up to 5 visits a year. The plan is gonna pay $50 towards that.
[CUSTOMER][NEUTRAL] OK, and that's $50 per visit, is that correct?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and have they used any of those 5 visits yet?
[AGENT][NEUTRAL] Yeah, let's take a look here.
[CUSTOMER][NEUTRAL] I think
[AGENT][NEUTRAL] I don't show that any have been used this year so they have the full amount still.
[CUSTOMER][NEUTRAL] OK, now this is for a PCP and a specialist, is that correct?
[AGENT][NEUTRAL] Yeah, it would be the same benefit amount regardless of yeah whether, yeah the same.
[CUSTOMER][NEUTRAL] The same.
[CUSTOMER][NEUTRAL] OK, does the plan cover annual physicals or no?
[AGENT][NEUTRAL] Um, it does cover, it looks like, yeah, physicals. It does have, it looks like a wellness benefit, uh, for that, which is $100.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Per visit, OK, and that's one per year correct?
[AGENT][POSITIVE] Uh, yes, that is correct. Uh-huh.
[CUSTOMER][NEUTRAL] OK, and have they used that one yet?
[AGENT][NEUTRAL] They have not.
[CUSTOMER][NEUTRAL] OK, one remaining.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, uh, do y'all give reference numbers?
[AGENT][NEUTRAL] Absolutely, [PII]. That's gonna be my name with my last initial and then today's date. So my name is [PII], which is [PII] My last initial is [PII] and then today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK all right thanks so much I appreciate your help.
[AGENT][POSITIVE] You're welcome [PII] a good one.
[CUSTOMER][NEUTRAL] You too bye bye.