AccountId: 011433970860
ContactId: 1451eb89-be92-40ed-85bf-2ae8790df149
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 370769 ms
Total Talk Time (AGENT): 190127 ms
Total Talk Time (CUSTOMER): 52458 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/1451eb89-be92-40ed-85bf-2ae8790df149_20250609T14:38_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes, [PII], my name is [PII] and I was calling to see how a patient's insurance covers global maternity.
[AGENT][NEUTRAL] And what do you mean by global maternity?
[CUSTOMER][NEUTRAL] Um, her prenatal care here in the office, her delivery.
[AGENT][NEUTRAL] Oh, everything.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, um, well, I'll be more than happy to help you with the maternity benefits, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes it's [PII].
[AGENT][NEUTRAL] Thank you. And may I have her policy number?
[CUSTOMER][NEUTRAL] It is 02596564.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify her first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And do you mind if I place you on just a brief hold so I can pull up the benefits?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, that's fine thank you.
[AGENT][NEUTRAL] You're welcome. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, policy number, where are you?
[AGENT][NEUTRAL] Wait,
[AGENT][NEUTRAL] That is that right? 2596564, OK.
[AGENT][NEUTRAL] OK, so.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] The confinement will be $100 a day.
[AGENT][NEUTRAL] Diagnostic testing.
[AGENT][NEUTRAL] First admission.
[AGENT][NEUTRAL] I make sure I understand that right because I'm gonna have to explain.
[AGENT][NEUTRAL] First time that confined to a hospital, OK. So that's right. That's what I thought. Confinement for this is what she'll be because whether it's 18 or 24, she, all right, so 24.
[AGENT][NEUTRAL] And then if a C-section is needed, she can use this. So it's and do, it's not like oh it's OK.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] All right, thank you so much for holding. I apologize for that wait. So she has a hospital indemnity policy with us, so it's a limited medical plan. Um, so for like once she's admitted and has been in the hospital for 24 hours, the um hospital confinement benefit can kick in, which would pay up to $100 per day.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, she has a wellness and diagnostic testing, um, benefit riders, so for diagnostic testing, the policy will pay up to $250 per test, one time per calendar year.
[CUSTOMER][NEUTRAL] So that'd be like an ultrasound.
[AGENT][NEUTRAL] Mhm. Um, let me see if this one specifies diagnostic testing. Some of them do.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So for this policy, the diagnostic testing is um specified for MRI, CT scan, or colonoscopy.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEUTRAL] Um, and then let me see what other benefits could apply.
[AGENT][NEUTRAL] Um, the first time that she's confined to the hospital, um, in the calendar year, the policy will pay up to $1500 so that's anytime after 24 hours.
[CUSTOMER][NEUTRAL] OK, and that's the max that pay.
[AGENT][NEUTRAL] Mhm. $1500 and then for like office visits, um the policy will pay up to $75 per visit with a max of 5 visits per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then like if C-section is needed or, you know, surgery, um, the policy will pay up to $2000 and then if anesthesia is needed, um it will be 25% of whatever was applied towards the surgery.
[CUSTOMER][NEUTRAL] But nothing for a vaginal birth, only for C-section.
[AGENT][NEUTRAL] Well, the, yeah, so the vaginal birth will still go under the confinement, but like there's a separate surgery benefit.
[CUSTOMER][POSITIVE] I got you, got you.
[CUSTOMER][NEUTRAL] OK, all right.
[CUSTOMER][NEUTRAL] And [PII], can I get a call reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] I think that's it, [PII], thank you so much.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too. Bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.