AccountId: 011433970860
ContactId: 115ed7cc-7605-43af-a77c-bfa644311dc0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 215899 ms
Total Talk Time (AGENT): 60337 ms
Total Talk Time (CUSTOMER): 86751 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/115ed7cc-7605-43af-a77c-bfa644311dc0_20250211T19:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling to get patients benefits for outpatient surgery.
[AGENT][NEUTRAL] OK, Ring, I can help you. What's the policy number?
[CUSTOMER][NEUTRAL] Uh, the policy number is going to be.
[CUSTOMER][NEUTRAL] 1526352
[AGENT][NEUTRAL] And what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] And my extension is [PII].
[AGENT][NEUTRAL] OK, what's a good, um, what's the patient's um name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information. And so you're checking eligibility and then you said this is outpatient surgery?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, I do have a procedure code.
[AGENT][NEUTRAL] OK, that's OK. um, we could, uh, provide the benefit for you. If you can just give me the description of the code if you would like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, it is a vasectomy.
[AGENT][NEUTRAL] Give me 1 2nd.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] I don't believe that uh sterilization is recovered, but I'm checking the exclusions of this policy. OK, give me one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Yeah, it's a sterilization and reversal of sterilization is not covered by this plan, so that's not a covered item.
[CUSTOMER][NEUTRAL] OK, because the patient uh is saying that he was told it was the way it's billed, and I told him, you know, originally when I checked, I would check for him again. Originally when I checked, the first representative did say that that was not a covered service or benefit for him.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And um so he spoke with someone and he said that they said it's the way we're billing it. I said, well, we actually have not billed it. We've only called to see if it was a covered benefit, um.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, I will uh give him a call and let him know, um.
[CUSTOMER][NEGATIVE] That it is definitely not a covered benefit.
[AGENT][NEUTRAL] Yeah, it's not covered by the policy.
[CUSTOMER][NEUTRAL] OK, um, and what was your name again?
[AGENT][NEUTRAL] Uh, it's [PII]. You'll use my name and today's date is your reference. [PII].
[AGENT][NEUTRAL] Oh NYA and first initial last name is [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright, and then today's date you said?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] It's a confirmation. OK, great.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] All right, Ms. [PII]. Thank you.
[AGENT][POSITIVE] Alrighty and thank you for calling APL have a good day.
[CUSTOMER][NEUTRAL] Mhm. Uh-huh. Bye-bye.