AccountId: 011433970860
ContactId: 36da4ea9-489c-4465-8610-2377ce5718f3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 568659 ms
Total Talk Time (AGENT): 129220 ms
Total Talk Time (CUSTOMER): 107528 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/36da4ea9-489c-4465-8610-2377ce5718f3_20250423T19:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APO. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, good afternoon, I'm calling for this ID number. What do I need to give you?
[AGENT][NEUTRAL] Do you have the policy number? It's uh the policy, sir.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, it's 024.
[CUSTOMER][NEUTRAL] 5170 M as in Mary, L as in Larry 8 number 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK. And then what did you say your name was?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and then what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] His last name is [PII], his first name is [PII]
[AGENT][NEUTRAL] OK, so that name and date of birth does not match this policy number.
[AGENT][NEUTRAL] You said the policy number was 724517?
[CUSTOMER][NEUTRAL] I have the card here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] His date of birth is [PII] and he's
[CUSTOMER][NEUTRAL] Group number no.
[CUSTOMER][NEUTRAL] What is it says in Hospital Benefits Central.
[CUSTOMER][NEUTRAL] And then it said outpatient outpatient has a different number and inpatient inpatient has a different number.
[CUSTOMER][NEUTRAL] It has um his name, his family coverage family, his group number is one.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] 5493.
[CUSTOMER][NEUTRAL] Effective [PII].
[AGENT][NEUTRAL] OK. Can I have his first and last name again?
[CUSTOMER][NEUTRAL] His first name is spelled [PII] and his last name is [PII]
[AGENT][NEUTRAL] OK, give me just one second, I'll try to look him up with his first and last name.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And his, his date of birth again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I found him. So his policy number is 214.
[CUSTOMER][NEUTRAL] 214.
[AGENT][NEUTRAL] 1794.
[CUSTOMER][NEUTRAL] 19794. OK, so that's what I'm gonna put here.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 214.
[CUSTOMER][NEUTRAL] 1794 OK.
[AGENT][NEUTRAL] OK. And then how can I help you today with this policy?
[CUSTOMER][NEUTRAL] He's having um.
[CUSTOMER][NEUTRAL] A colonoscopy.
[CUSTOMER][NEUTRAL] So I want to know what he has, what, what's his benefits? what is.
[CUSTOMER][POSITIVE] effective since when and what how much he has.
[AGENT][NEUTRAL] OK. I can help you with eligibility today and checking those benefits.
[AGENT][NEUTRAL] OK, so it looks like his policy is active. The effective date is [PII].
[AGENT][NEUTRAL] OK, just one second while I pull up his certificate so I can look into his benefits.
[AGENT][NEUTRAL] Sorry, just a minute. I'm trying to look up to see if this policy covers colonoscopy.
[AGENT][NEUTRAL] OK, this is not a guarantee of payment, just a verification of coverage.
[AGENT][NEUTRAL] So is the colonoscopy performed in a physician's office or a specialist?
[CUSTOMER][NEUTRAL] No, at the facility, no, we're a facility ambulatory surgical center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so that would fall under our outpatient benefit max, and that is 7900 per covered person per calendar year.
[AGENT][NEUTRAL] For covered outpatient services.
[CUSTOMER][NEUTRAL] OK, and they haven't been anything, right?
[AGENT][NEUTRAL] Uh, let me double check for you.
[AGENT][NEUTRAL] No, they have not used anything as of this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what is your name?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] And your initial?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And a reference number?
[AGENT][NEUTRAL] It would be my first name, last initial, and today's date.
[CUSTOMER][POSITIVE] In today too, OK, honey, thank you so much, OK.
[AGENT][POSITIVE] OK. Thank you. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Uh, that's it, thanks.
[AGENT][POSITIVE] OK, yeah, thanks for calling APL. Have a good day. Bye.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] OK bye.