AccountId: 011433970860
ContactId: 54e6e761-4c8f-48e3-9d01-6df3476e41e8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236000 ms
Total Talk Time (AGENT): 124640 ms
Total Talk Time (CUSTOMER): 80590 ms
Interruptions: 0
Overall Sentiment: AGENT=2.4, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/54e6e761-4c8f-48e3-9d01-6df3476e41e8_20250501T16:20_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling APL this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I am calling because I had a question.
[CUSTOMER][NEUTRAL] About um my benefits and coverage.
[AGENT][POSITIVE] Sure, I can take a look at those benefits for you. uh, [PII], can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have your policy number?
[CUSTOMER][NEUTRAL] Um, yes, I do. It is 02575984.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, one moment please.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, [PII], just gonna verify some information really quick. Uh, can I get your date of birth, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] Perfect. Last thing I need is the email address we've got on file for you. uh, looks like it is a Gmail account.
[CUSTOMER][NEUTRAL] Yes, it would be [PII].
[AGENT][POSITIVE] Awesome thank you so much for verifying that. OK, what kind of questions did you have for me, [PII]?
[CUSTOMER][NEUTRAL] Um, I received a bill from, um, the anesthesiologist for my surgery.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I was calling to see if that is covered.
[AGENT][NEUTRAL] Yeah, it absolutely should be um do you know if they uh have this information on file?
[AGENT][NEUTRAL] The provider?
[CUSTOMER][NEUTRAL] I, I provided um the APL.
[CUSTOMER][NEGATIVE] Um, hard whenever I went in to have surgery.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] And it doesn't show that they tried to bill you guys or anything.
[CUSTOMER][NEUTRAL] So I'm not, I'm not sure and I'm not showing anything online.
[AGENT][NEUTRAL] Yeah, I
[AGENT][NEUTRAL] That's fine.
[AGENT][NEUTRAL] Right. And that's why I asked. Um, and it could be, you know, they might not have gotten around to it yet. I know some providers can be a bit, you know, could take a bit longer. Um, but yeah, I'm definitely not showing that we've received any claims. So, um, where was the, where did the surgery take place? Was it in an actual hospital? Oh, it was an outpatient uh surgery, correct?
[CUSTOMER][NEUTRAL] No, it, it had occurred in the hospital.
[AGENT][NEUTRAL] OK, were you hospitalized for more than one day?
[CUSTOMER][NEUTRAL] Um, no, I think I was just there for 24ish or so hours.
[AGENT][NEUTRAL] OK, um, so if it was less than a day, um, that would typically be considered uh outpatient if it wasn't, if it was longer than that, it would be considered inpatient so as long as it was in an actual hospital facility, um, yeah, you should definitely have coverage coverage for that and of course I'm not showing that we've received any claims for you so you have that full benefit amount.
[AGENT][POSITIVE] I would get with them and just double check um that they're gonna be filing that claim if there's any confusion or they're not certain about this policy or anything they are more than welcome to give us a call and we can kinda uh you know hopefully clear up any confusion and explain the benefits and how this plan works.
[CUSTOMER][POSITIVE] OK, I appreciate your help. Thank you very much.
[AGENT][POSITIVE] Sure yeah and just know that if they don't uh for some reason want to file a claim or something like that you can still do that. It's just, you know, obviously be a lot easier for you if they would be able to do that for you.
[CUSTOMER][NEUTRAL] Right, OK, I will let them know.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Sounds good. Did you have any other questions for me, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, that would be it.
[AGENT][POSITIVE] Alright well thanks for giving us a call I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.