AccountId: 011433970860
ContactId: dbf72683-fdbd-4eca-adc6-455fd699056e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226899 ms
Total Talk Time (AGENT): 75493 ms
Total Talk Time (CUSTOMER): 65410 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/dbf72683-fdbd-4eca-adc6-455fd699056e_20250314T13:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, I'm calling from Doctor [PII]'s office. I need to go with benefits on the patients.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, can I place you on a brief hold?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK. Thank you, ma'am, for your patience. Um, can I get your name and a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII]. It's [PII] [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] It is 02255674 ML8.
[AGENT][NEUTRAL] OK. And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Surgeries Batista [PII].
[AGENT][NEUTRAL] Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] For our patients, for it's um patient has a deductible with its primary plan, so any procedures under in the office would be subject to the deductible. So this this um policy, this plan.
[CUSTOMER][NEUTRAL] Um, cover procedures rented in the doctor's office.
[AGENT][NEUTRAL] OK. No, ma'am. I'm showing that for services provided in the doctor's office is not covered under this policy. I'm only showing coverage for inpatient and outpatient hospital and urgent care facilities.
[CUSTOMER][NEUTRAL] So, um, in having office surgery is not considered outpatient?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] I mean, yeah, outpatient yeah sometimes they consider that outpatient when you're having an office surgery not office visit office surgery.
[AGENT][NEUTRAL] Right. Um, we, it will be covered under office treatments and office treatments is not covered under this policy either.
[CUSTOMER][NEUTRAL] OK, so he doesn't have benefits for office for procedures or in the doctor's office. OK, so may I have a reference number for the call. Thank you.
[AGENT][POSITIVE] That's correct, yes, ma'am.
[AGENT][NEUTRAL] Mhm. For the reference number, you can use my name and today's date. My name is [PII]. um it's spelled [PII]
[CUSTOMER][NEUTRAL] And what
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I
[CUSTOMER][POSITIVE] OK, [PII]. OK, alright, [PII] and today state I think thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] No, that's all thanks.
[AGENT][POSITIVE] Mhm. Thanks again, [PII], for calling APL. Have a great weekend. Bye.
[CUSTOMER][POSITIVE] You're welcome bye bye you too.
[AGENT][POSITIVE] Thanks.