AccountId: 011433970860
ContactId: 038d66b4-4fdf-4801-9a52-e935b4c7af60
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 238770 ms
Total Talk Time (AGENT): 77453 ms
Total Talk Time (CUSTOMER): 74260 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/038d66b4-4fdf-4801-9a52-e935b4c7af60_20250417T15:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes ma'am, I was calling to see if precert was required for a code.
[AGENT][NEUTRAL] OK, may I have your name and a callback number?
[CUSTOMER][NEUTRAL] [PII] and it's [PII] and then with the Arkansas Heart Hospital.
[AGENT][NEUTRAL] OK, and may I please have the policy number?
[CUSTOMER][NEUTRAL] It says 02582808.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[AGENT][NEUTRAL] And you're calling to see if pre-cer is required for this policy?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so for this policy, no pre-cert is required.
[CUSTOMER][NEUTRAL] OK, and that is.
[CUSTOMER][NEUTRAL] Is it just hospital benefits or?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] For this policy, it's an, it's an indemnity benefit, which is a limited benefit plan. So it's just not hospital only.
[CUSTOMER][NEUTRAL] I was looking at the card and I, yes ma'am.
[CUSTOMER][NEUTRAL] Limited.
[CUSTOMER][NEUTRAL] It's hospital only.
[AGENT][NEUTRAL] No, I said it's just not hospital only. It's a limited benefit plan.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] And then if they have something scheduled for outpatient surgery, would that be covered then?
[AGENT][NEUTRAL] Let me pull up the benefits up for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And this is for outpatient facility for surgery?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] In regards to outpatient benefits, verification of coverage does not guarantee the payment of the claim.
[AGENT][NEUTRAL] For surgery within a hospital outpatient facility, the member does have up to $250 per day, with a maximum of 1 day per calendar year per COVID person.
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] OK, and that's limited.
[CUSTOMER][NEUTRAL] Benefit plan.
[CUSTOMER][NEUTRAL] And would there be a chance you could tell me if we were in that work for them or?
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] You can either go into the multiplayer network to see.
[AGENT][NEUTRAL] But it's not really based off of in or out of network.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK, I got you and then is there a call reference for us today?
[AGENT][NEUTRAL] The call reference will be my first name, [PII], spelled [PII] last [PII] and today's date.
[CUSTOMER][POSITIVE] OK, thank you ma'am you have a good day.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day as well, [PII]. Bye.
[CUSTOMER][NEUTRAL] Uh you too bye bye.