AccountId: 011433970860
ContactId: 55d164fd-0c1f-4a28-a792-62000fb571fa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 232979 ms
Total Talk Time (AGENT): 110830 ms
Total Talk Time (CUSTOMER): 43184 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/55d164fd-0c1f-4a28-a792-62000fb571fa_20250220T15:11_UTC.wav
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[AGENT][POSITIVE] Good morning thank you for calling APO. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling to check eligibility for a patient please.
[AGENT][NEUTRAL] OK, sure. I can assist you with the eligibility. And may I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and may I have a callback number just in case we get disconnected, Miss [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And um where are you calling from? What's the name of the facility or the provider?
[CUSTOMER][NEUTRAL] Mercy Hospital, Fort [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Yes, it is 025.
[CUSTOMER][NEUTRAL] 883-22.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] That is for [PII], [PII].
[AGENT][NEUTRAL] All right. Thank you. OK, and you said you need eligibility. We have an effective date of December, no, not December, it's um [PII].
[AGENT][NEUTRAL] Um, it is active at the moment, and this is one of our limited indemnity plans.
[CUSTOMER][NEUTRAL] Limited indemnity. Does this plan cover colorectal screenings?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Like a colonoscopy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Is it gonna be a um preventative colonoscopy or diagnostic colonoscopy?
[CUSTOMER][NEUTRAL] Preventative.
[AGENT][NEUTRAL] OK, let me check and see if this one covers preventative. OK, one moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] It's gonna be a minute. I'm waiting on the documents to pull up, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] All right, here we go.
[AGENT][NEUTRAL] So their diagnostic.
[AGENT][NEGATIVE] No, this one doesn't have any preventative benefit in um.
[AGENT][NEUTRAL] There's no preventative service benefits for this member under this policy.
[CUSTOMER][NEUTRAL] So it will not be covered?
[AGENT][NEUTRAL] No, unless it becomes diagnostic like it unless you find poly then it becomes a surgery, then it will be considered under the surgical benefit, but if it's just preventative, it will not be covered under the policy. This one doesn't have any preventative coverage.
[CUSTOMER][NEUTRAL] OK, only covered if diagnostic.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Sorry, you're breaking up. Did you say yes?
[AGENT][POSITIVE] Yes, correct, yes. Mhm.
[CUSTOMER][NEUTRAL] OK, and what was your first name?
[AGENT][NEUTRAL] My name is [PII] [PII].
[CUSTOMER][NEUTRAL] OK, and a reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Is there anything else I may help you with today, Miss [PII]?
[CUSTOMER][POSITIVE] That's it. Thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day, Ms. [PII].
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.