AccountId: 011433970860
ContactId: 2bc4abd6-cbca-4f29-a030-e55e3d14d9c5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285489 ms
Total Talk Time (AGENT): 102005 ms
Total Talk Time (CUSTOMER): 110060 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/2bc4abd6-cbca-4f29-a030-e55e3d14d9c5_20250506T18:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, hi, [PII]. This is [PII] in the Midland Claims department. Um, I have a provider on the line who's calling in regards to, um, benefits for a hospital indemnity policy, and she needs more specific information than I can give her. Would you be able to be able to further assist her?
[AGENT][NEUTRAL] Yeah, let's give it a go. Do we have a policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is 02044285.
[CUSTOMER][NEUTRAL] For [PII].
[AGENT][NEUTRAL] OK, and then who are we talking to on the line?
[CUSTOMER][NEUTRAL] Her name is [PII] and her callback number is [PII].
[AGENT][NEUTRAL] Alright, if you wanna go ahead and send [PII] over I can take the call.
[CUSTOMER][POSITIVE] OK, I appreciate it. Have a good rest of your day.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You too.
[CUSTOMER][POSITIVE] All right, please. Thanks.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] This is [PII] in the customer care department. Am I speaking with [PII]?
[CUSTOMER][NEUTRAL] [PII] you are, how are you?
[AGENT][POSITIVE] I'm good, [PII]. How are you today?
[CUSTOMER][NEUTRAL] He initial?
[CUSTOMER][NEUTRAL] I'm OK. I'm ready for the day to be ended or what about you?
[AGENT][NEUTRAL] I hear you, I hear you. Um, how can I help you today with, uh, [PII]'s plan?
[CUSTOMER][NEUTRAL] Um, he is scheduled for a screening colonoscopy outpatient hospital.
[CUSTOMER][NEUTRAL] And I'm calling to check if he has benefits and to see if he requires an authorization.
[AGENT][NEUTRAL] OK, no pre-op is required with any of our plans.
[AGENT][NEUTRAL] Um, it looks like
[AGENT][NEUTRAL] The patient's plan has an outpatient benefit max.
[AGENT][NEUTRAL] For per visit of $100 and then any testing, it's gonna cover 1 per calendar year and it's a maximum benefit of $400.
[CUSTOMER][NEUTRAL] Uh uh.
[CUSTOMER][NEUTRAL] OK, so hold on, so he has a $100 max.
[AGENT][NEUTRAL] Per day, per visit with a physician. So any visit to the physician's office, the plan's gonna pay $100 towards that visit.
[AGENT][NEUTRAL] And they're allowed 4 visits.
[CUSTOMER][NEUTRAL] OK, now this is
[CUSTOMER][NEUTRAL] This is gonna be outpatient hospital.
[CUSTOMER][NEUTRAL] This is an actual surgery.
[AGENT][NEUTRAL] So the benefit max for that is 1 per calendar year, and it's a maximum benefit payment of $2000 for surgery in a hospital, outpatient facility, or freestanding surgery center.
[CUSTOMER][NEUTRAL] OK, so it is covered and there is no copay, uh, no pre-cert required.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, can I have a call reference number?
[AGENT][NEUTRAL] That's my name with my last initial and today's date. My name is [PII], initial to my last name, [PII], then today's date.
[CUSTOMER][NEUTRAL] OK, so [PII], what is today? [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Ancient pressure
[CUSTOMER][NEUTRAL] OK, so 1 per calendar year $2000.
[CUSTOMER][NEUTRAL] Oh
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Is that what you said 1 $2000 coverage?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] That's the max benefit, yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so one per calendar year.
[CUSTOMER][NEUTRAL] Max coverage is $2000. OK.
[CUSTOMER][POSITIVE] All right, that's all I needed thank you.
[AGENT][NEUTRAL] Anything else?
[AGENT][POSITIVE] You're welcome, [PII]. Have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] No, thank you.