AccountId: 011433970860
ContactId: fb9e229b-7a34-4d9d-a8aa-9d05c5d6d05e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 239990 ms
Total Talk Time (AGENT): 90708 ms
Total Talk Time (CUSTOMER): 88622 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/fb9e229b-7a34-4d9d-a8aa-9d05c5d6d05e_20250417T13:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm just calling to get benefits for a, uh, patient, uh, this would for.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, I can help you with benefits. Do you have a, um, can I get your name and a good callback number, please?
[CUSTOMER][NEUTRAL] Yes, uh, my name is [PII]. Call back number [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. Uh, do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Uh yes, it is 00973964.
[AGENT][NEUTRAL] And what was that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII]. Date of birth [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, this is not a guarantee of payment basic outline of the policy. It is for outpatient services.
[CUSTOMER][NEUTRAL] Uh, yes, it would just be for a specialist office, is it?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Effective date is [PII]. It's currently active.
[AGENT][NEUTRAL] And then for that benefit,
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] And so they don't have any benefit for the actual office visit?
[AGENT][NEUTRAL] Um, this is a supplemental policy, uh, it pays a secondary after primary pays.
[AGENT][NEUTRAL] Are there gonna be any procedures in the office?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, well, it looks like it's just a consult, um, so now.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Would they, would this pick up like if she, like her did I say she has a deductible for her um ultrasound or something, would this pick this up for uh the deductible or?
[AGENT][NEUTRAL] So, they do have a $500 per covered person per calendar day benefit. That would be for diagnostic testing in a hospital, outpatient facility, or MRI facility.
[AGENT][NEUTRAL] So it has to be in a hospital setting.
[CUSTOMER][NEUTRAL] Oh I see OK.
[CUSTOMER][NEUTRAL] OK, so that you, you wouldn't pick up copays or anything like that. It would just be um.
[CUSTOMER][NEUTRAL] So what, what exact, so the only thing that you would outpatient like procedure or.
[AGENT][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] Yeah, so it'd be the.
[CUSTOMER][NEUTRAL] Nothing is done in the office.
[AGENT][NEUTRAL] Correct, yeah, it looks like they do have um benefits if it's hospital emergency room, urgent care facility, um, out outpatient surgery in a hospital, um, they do have physical therapy facility, um, diagnostic testing in hospital outpatient facility or MRI facility, um, and then they have outpatient treatment for mental or emotional disorders in hospital.
[AGENT][NEUTRAL] So basically it's all hospitals.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, I see, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, I think that's all I needed um do you give out reference numbers by chance?
[AGENT][NEUTRAL] And it's just my name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][POSITIVE] Perfect alright well thank you so much I appreciate your time.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.