AccountId: 011433970860
ContactId: d09815d0-5402-4c78-a64e-ebfcbf11c786
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204779 ms
Total Talk Time (AGENT): 108716 ms
Total Talk Time (CUSTOMER): 79127 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/d09815d0-5402-4c78-a64e-ebfcbf11c786_20250317T12:49_UTC.wav
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[AGENT][POSITIVE] Good Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from South Florida ENT. How are you?
[AGENT][POSITIVE] I'm doing well, [PII], thank you for asking. How are you today?
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][POSITIVE] I'm good, thank you. [PII]. I'm calling to check the benefits for a patient because I'm getting an unknown error on his benefits for his APL.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you with benefits, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII], and what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Um, the policy number that I have is 02, he doesn't physically have the card here, 02497482.
[CUSTOMER][NEUTRAL] ML, uh, forgot what the ML was.
[AGENT][NEUTRAL] That's fine. We don't need the ML. I got it. That's not a problem. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] S, Date of birth [PII].
[AGENT][POSITIVE] Alright, thank you, and it would be my pleasure to assist you with those benefits for [PII]. I am showing his policy is active.
[AGENT][NEUTRAL] Effective date is [PII].
[AGENT][NEUTRAL] And this is a secondary policy to his major medical.
[AGENT][NEUTRAL] And what type of benefits are you needing?
[CUSTOMER][NEUTRAL] I need to know if his office visits, his co-pay is covered, and if his office procedures are covered for outpatient.
[AGENT][POSITIVE] All right, and I can certainly help you with that.
[AGENT][POSITIVE] I'm getting those benefits pulled up. Bear with me just a quick second.
[CUSTOMER][NEUTRAL] your
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Is this a, a primary or specialist?
[CUSTOMER][NEUTRAL] A specialist.
[AGENT][POSITIVE] OK, great. Thank you.
[AGENT][NEUTRAL] It's coming up slowly but surely bear with me. He does have benefits for the office visit co-pay and procedures in the office. For specialists, we can pay up to $50 per visit, maximum of 4 visits per calendar year.
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And then for his treatment or procedure in office, that benefit amount is up to $2500 per calendar year. Now that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And we're secondary to the policyholders' major medical.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, perfect. Is there any way that you can let me know if any of that has been used yet, like if his 4 office visits have been used yet?
[AGENT][NEUTRAL] They have not for [PII]. He has not used any benefits for [PII] as of yet.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] Alright, perfect. [PII], can I have a reference number for the call?
[AGENT][NEUTRAL] Reference number is my name and today's date. I spell my name [PII]
[AGENT][NEUTRAL] First initial last name [PII].
[CUSTOMER][POSITIVE] Alrighty perfect that's all I need thank you so much for your time have a good day.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I hope you have a wonderful day as well, [PII]. Thank you for calling APL. Have a wonderful day.
[CUSTOMER][POSITIVE] Hey you too. You too. Bye-bye.
[AGENT][NEUTRAL] Bye bye.