AccountId: 011433970860
ContactId: daaf5b50-aae8-45f5-b45d-00cb22d04b4b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180300 ms
Total Talk Time (AGENT): 90815 ms
Total Talk Time (CUSTOMER): 79791 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/daaf5b50-aae8-45f5-b45d-00cb22d04b4b_20250417T18:27_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from a doctor's office, um, and this patient has this as their secondary, and I was calling to see if there's any coverage for office visits specialists.
[AGENT][NEUTRAL] Can I have your name and the callback number?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you, [PII], and can I have the policy number of the member and then I'll be able to assist you with your request.
[CUSTOMER][POSITIVE] Thank you. It's 025793992.
[AGENT][NEUTRAL] What's this member's name and date of birth?
[CUSTOMER][NEUTRAL] I have a group too.
[CUSTOMER][NEUTRAL] It's [PII]. Last name is [PII] Her date of birth is [PII]. OK.
[AGENT][NEUTRAL] I don't blame you.
[CUSTOMER][NEUTRAL] Her birthday is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're calling to verify office visits, so her policy has been active since [PII] and it's currently active.
[AGENT][NEUTRAL] She does not have office business benefits.
[AGENT][NEUTRAL] However, she does have the treatment rider, meaning that whatever is, whatever type of treatment is received in the office, it falls under her outpatient benefits of $500 per calendar day.
[CUSTOMER][NEUTRAL] Oh, patient benefits I I.
[AGENT][NEUTRAL] And this is not a guarantee of benefits just a disclaimer of the policy's coverage.
[AGENT][NEUTRAL] And when I say the treatment received in the office, like, say if she get an X-ray or
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Ultrasound or she broke her thumb and you gotta look at her thumb, you gotta give stitches or something of that matter. It's covered, that'll be covered but just not the office visit itself.
[AGENT][NEUTRAL] I know it's like what?
[CUSTOMER][NEUTRAL] OK, so we don't do any testing. Yeah, I was gonna ask you and then you just answered it for me. Thank you, but we don't do any imaging. So it's Pam it's OK, PAM. So if we were to do a procedure on her, on her in the office, it'd be covered.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what was your name again? I do apologize.
[AGENT][NEUTRAL] Any procedure. Yes.
[CUSTOMER][NEUTRAL] You said oh OK and it's she's allowed 500 per day?
[AGENT][NEUTRAL] Yes, 500 per calendar day.
[CUSTOMER][POSITIVE] Oh wow, that's awesome. About 500 per calendar day and what's the [PII]?
[AGENT][NEUTRAL] 6
[AGENT][NEUTRAL] [PII]. [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] and what's your name again?
[AGENT][NEUTRAL] [PII] and today's date as a reference.
[CUSTOMER][POSITIVE] OK, thank you, [PII]. Have a wonderful day.
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APL. You have a great one as well. Stay safe.
[CUSTOMER][POSITIVE] You too thanks bye.
[AGENT][POSITIVE] Thanks bye.