AccountId: 011433970860
ContactId: cf9932a9-6417-439d-9b8b-45629b1b28a4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 198820 ms
Total Talk Time (AGENT): 74567 ms
Total Talk Time (CUSTOMER): 75240 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/cf9932a9-6417-439d-9b8b-45629b1b28a4_20250124T15:10_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi, how are you? I was calling to check a member's benefits.
[AGENT][NEUTRAL] OK, is this for service in a doctor's office?
[CUSTOMER][POSITIVE] Uh yes, correct.
[AGENT][NEUTRAL] OK, and your name?
[CUSTOMER][NEUTRAL] Uh, my name is [PII].
[AGENT][NEUTRAL] Spell your name for me?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] OK, and the policy number and a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK. The ID is 02576820 ML8.
[CUSTOMER][NEUTRAL] And um the number is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh sorry, [PII].
[AGENT][NEUTRAL] [PII] OK.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] OK, thanks for that information, [PII]. I'm showing the policy effective date is [PII]. This policy is active at this time. Uh, the physician visit fee is not covered under this policy. Um, I do show that there is a treatment writer, so if there's treatment in the office, those items can be covered items can be considered if you would like that benefit.
[CUSTOMER][NEUTRAL] Uh, yes, please. Uh, they would be done for allergy testing and allergy shots and serum.
[AGENT][NEUTRAL] OK, so the maximum outpatient benefit is up to $1500.
[AGENT][NEUTRAL] Her calendar year.
[AGENT][NEUTRAL] And information provided is verification, not a guarantee of payment, uh, currently do not show any of that benefit used.
[CUSTOMER][NEUTRAL] OK. OK, perfect. And um if it's a specialist, uh a visit, it's still not covered, correct?
[AGENT][NEGATIVE] The physician visit isn't correct.
[CUSTOMER][NEUTRAL] Yes. OK. OK. And um, would they require referrals?
[AGENT][NEUTRAL] Referral is not required.
[CUSTOMER][POSITIVE] Yeah, OK, perfect.
[CUSTOMER][NEUTRAL] And um let me see. OK. And then I wanted to check the claim's mailing address.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. Correct?
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Yeah. OK. Perfect.
[CUSTOMER][NEUTRAL] OK. And um uh yes, then I think that would be uh everything I needed. I would just need a reference number for this call.
[AGENT][NEUTRAL] My name in today's date, [PII]. Any other questions?
[CUSTOMER][POSITIVE] Um, no, that would be everything. Thank you so much.
[AGENT][POSITIVE] Alrighty, thanks for calling APL have a good day.
[CUSTOMER][POSITIVE] Thank you. You too.