AccountId: 011433970860
ContactId: 1255b338-03a6-46f9-b26b-56b57ef4dd5a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235320 ms
Total Talk Time (AGENT): 94111 ms
Total Talk Time (CUSTOMER): 108115 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/1255b338-03a6-46f9-b26b-56b57ef4dd5a_20250613T20:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, this is [PII] calling. I have a um surgery.
[CUSTOMER][NEGATIVE] That is scheduled on [PII] and it's gonna be a um I'm gonna be hospitalized.
[CUSTOMER][NEUTRAL] So, I would like to get um the coverage for that procedure.
[AGENT][NEUTRAL] Um, yes, ma'am.
[CUSTOMER][NEUTRAL] That it's under your the APL. Mhm.
[AGENT][POSITIVE] OK. Yes, ma'am. I can assist you with your benefits. Um, first, could I get your name again and a callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh
[AGENT][POSITIVE] Thank you, [PII] and
[CUSTOMER][NEUTRAL] And the number is [PII].
[AGENT][NEUTRAL] Mhm. Go ahead.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Uh, let's see.
[CUSTOMER][NEUTRAL] Is that the same thing as the er number?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Or the
[CUSTOMER][NEUTRAL] The third number, OK. 02153725 ML 7.
[AGENT][NEUTRAL] OK. Thank you, [PII], and please verify your date of birth and your mailing address.
[CUSTOMER][NEUTRAL] Um, date of birth [PII].
[CUSTOMER][NEUTRAL] Address is [PII].
[AGENT][NEUTRAL] OK, and please verify your email address.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK. And will this be uh inpatient or outpatient surgery?
[CUSTOMER][NEUTRAL] Inpatient.
[AGENT][NEUTRAL] OK. Yes, ma'am. I'm showing that under your policy for um inpatient services, we cover up to 3500 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Correct. So, how, how, um, so what's the process to get that um applied?
[CUSTOMER][NEUTRAL] To the, um, so do you pay directly to the hospital or do I pay and then you reimburse me?
[AGENT][NEUTRAL] Um, normally, you'll um let the hospital know that you have insurance with us. They will call us to verify, um, benefits and see how to submit a claim if they're not familiar with us. Normally, the provider, um, themselves will submit the claim and we'll pay them directly.
[AGENT][NEUTRAL] But um if that doesn't happen, then yes, you can pay upfront and um we'll reimburse you, but normally the provider will file the claim. Just um give them my phone number and your policy number so they can call to verify your benefits.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, perfect. So what will be the best number for them to call you? The same number that I that I dial?
[AGENT][NEUTRAL] Is it, did you dial the [PII] number?
[CUSTOMER][NEUTRAL] Uh yes ma'am.
[AGENT][NEUTRAL] OK. Yes, ma'am. That's the correct number and give them your policy number.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] OK, I'll do that. Thank you very much.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh, no, that was it.
[AGENT][POSITIVE] OK. Thank you again, [PII] for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Thank you. You too. Bye.
[AGENT][POSITIVE] Mm thank you