AccountId: 011433970860
ContactId: 228dd118-7c42-406e-a034-4b9ae5960db4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 148419 ms
Total Talk Time (AGENT): 77564 ms
Total Talk Time (CUSTOMER): 44568 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/228dd118-7c42-406e-a034-4b9ae5960db4_20250318T18:18_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from Novit Health Medical Park Hospital. I have a member here that's gonna have an outpatient surgery, and I need to check the CPT codes, please, to see if authorization is required.
[AGENT][NEUTRAL] Oh, OK, um, I can check the policy for you, but none of our policies require authorization or pre-cert because we're not a major medical, but I can let you know if we cover the outpatient surgery if you like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] And that policy number is 02595081.
[AGENT][NEUTRAL] Alright, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you, and all the information provided is a verification of benefits, not a guarantee of payment. I am showing the policy is active, it's been effective since [PII]. This is a hospital indemnity policy. I'm waiting to look for the benefits. Hold on one moment.
[AGENT][NEUTRAL] So for surgery in a hospital, hospital outpatient facility or freestanding outpatient surgery center, the policy would pay up to $500 per day with a max of 1 day per calendar year. Do you want me to see if that's being used for this year?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] It has not, so, um, they still have that $500 benefit that they can use towards the surgery.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, well I thank you so much. Is there a call reference?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII], my first name is [PII]
[CUSTOMER][POSITIVE] OK. OK. Thank you so much.
[AGENT][POSITIVE] You're very welcome. Thanks for calling APL [PII]. I hope you have a good day.
[CUSTOMER][POSITIVE] You too. Thank you. Bye bye.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] Mhm.