AccountId: 011433970860
ContactId: 044701dc-7c58-46d8-96f7-8ece59dd29c1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249000 ms
Total Talk Time (AGENT): 130721 ms
Total Talk Time (CUSTOMER): 109760 ms
Interruptions: 1
Overall Sentiment: AGENT=1.8, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/044701dc-7c58-46d8-96f7-8ece59dd29c1_20250207T15:17_UTC.wav
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[AGENT][POSITIVE] Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] from Kendal endoscopy and surgery center. I need benefit in one of our patients, please.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you with benefits, and I'm sorry, what was your name? Is it [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Thank you [PII], and what is a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number?
[CUSTOMER][NEUTRAL] 022.
[CUSTOMER][NEUTRAL] 70639.
[AGENT][NEUTRAL] And what is the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] Uh, the patient name is [PII].
[CUSTOMER][NEUTRAL] Go [PII] something like that. The date of birth is [PII] so weird. The last name uh [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, thank you, Miss, and I have no idea how to pronounce that last name.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] Not at all. No.
[AGENT][NEUTRAL] I have never seen anything like that before.
[CUSTOMER][NEUTRAL] Me too.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Oh goodness, I will be happy to assist you with eligibility and benefits for walls. I can't even do the first name for the patient.
[CUSTOMER][NEUTRAL] [PII] something like that, yes, yes.
[AGENT][NEUTRAL] Yes, so I'm showing this policy is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is a secondary policy to the policyholder's major medical insurance.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Are you needing specific benefits?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] No, he's coming to have a colonoscopy, uh, I'm sorry, an endoscopy, and, uh, I just wanna know if this is like his secondary and it's actually I have the, the funds.
[AGENT][NEUTRAL] Let's see. Now, let me check on that benefit for an endoscopy. This looks more like an inpatient hospital's policy, but I'm gonna check that for you. Yeah. Give me just one second.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Out outpatient.
[CUSTOMER][NEUTRAL] It's in a free standing facility, right?
[AGENT][POSITIVE] OK, thank you. Give me just one second.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] I apologize. It's taking me just a minute.
[CUSTOMER][POSITIVE] No, not a problem.
[AGENT][NEUTRAL] Well, come on computer.
[AGENT][POSITIVE] Got to encourage it a little bit.
[CUSTOMER][NEUTRAL] I is the computer know that today is Friday and she's taking the time, you know, is that.
[AGENT][NEUTRAL] I, I think so. I think so.
[AGENT][NEUTRAL] I've had enough
[CUSTOMER][POSITIVE] Yes, you're right.
[AGENT][NEUTRAL] OK, so the policy does provide an outpatient benefit.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] And that is for diagnostic testing as well. It covers up to $750 per calendar year per person.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] How much you say?
[AGENT][NEUTRAL] And that $750.
[CUSTOMER][NEUTRAL] For per calendar year.
[AGENT][NEUTRAL] That's correct, and that is what we can pay for the deductible, copay, or co-insurance of the major medical.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And if you would please note that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I got it. OK, and this is a supplemental insurance for him, right?
[AGENT][NEUTRAL] That's correct. It is secondary to the patient, the policyholders Ma Medical.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][POSITIVE] OK, perfect. Alrighty, that's good to know. May I have a reference number please?
[AGENT][NEUTRAL] Reference number is my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] OK, that's fine thank you have a wonderful day.
[AGENT][POSITIVE] Oh no, it's been a pleasure to help you with that eligibility and benefits. I hope you have a wonderful day as well and a very happy weekend.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you, [PII] bye bye.
[CUSTOMER][NEUTRAL] Bye bye.