AccountId: 011433970860
ContactId: 65b814fc-0515-40eb-80d1-1a6ec9458133
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 298679 ms
Total Talk Time (AGENT): 150390 ms
Total Talk Time (CUSTOMER): 68875 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/65b814fc-0515-40eb-80d1-1a6ec9458133_20250320T20:30_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], my name is [PII], and I'm calling to verify eligibility and benefits on a patient.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility and the benefits. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure it is [PII] I'm [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] That would be 02598062.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Museum.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] That would be [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing that the policy is active. It's been effective since [PII]. And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] She is scheduled for, um, all I need is um benefits for ambulatory surgery center.
[AGENT][NEUTRAL] So, this policy is a hospital indemnity policy, so it's a limited medical policy. Now, there are outpatient benefits, but it's for like emergency room, urgent care, physician office, physical therapy. Are you mean like surgery in the outpatient facility?
[CUSTOMER][NEUTRAL] Yes, yes, she's scheduled for an endoscopy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, now there is diagnostic testing that we have a benefit for, um, diagnostic testing, the first one would be 100.
[AGENT][NEUTRAL] Um, dollars, um, so it's
[AGENT][NEUTRAL] It'll pay one time per calendar year with a max of $100. Did you want me to see if the endoscopy could be included at the diagnostic testing? We could try it that way. OK, hold on one moment.
[CUSTOMER][NEUTRAL] Please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], do you mind if I place you on just a brief hold while I look at the benefits?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, and that's, well, let me see, as long as it doesn't die.
[AGENT][NEUTRAL] Oh, it specifies. OK.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] OK. So it's these, but if a follow-up is needed, it'll also cover the, OK.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] All right, thank you so much for holding. I apologize for that wait. So for this particular policy, it specifies the diagnostic testing, um, so it's for MRI, CAT scan, um, RAIU testing, CT scans, and PET scans.
[AGENT][NEUTRAL] Um, so, endoscopies aren't one of the scans, so they wouldn't be able to use this policy.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, OK, and you said it's mainly for, I guess for hospital, hospital, and you said even office visit like physician.
[AGENT][NEUTRAL] Yes, for physician office, um, the benefit is up to $50.04 times per calendar year, the policy would pay towards.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, in hospital.
[CUSTOMER][NEUTRAL] OK, not outpatient, correct, not outpatient services, not an outpatient surgery.
[AGENT][NEUTRAL] Right, like outpatient surgery. Right. Mhm.
[CUSTOMER][NEUTRAL] OK, alright, and do you have a car reference number?
[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].
[CUSTOMER][POSITIVE] Alright, thank you so much for your help.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Uh, no, that's all, thank you so much.
[AGENT][POSITIVE] All right, thanks for calling APR. Have a great day. Bye-bye.
[CUSTOMER][POSITIVE] You as well thank you bye bye.
[AGENT][POSITIVE] You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Welcome to our survey.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Overall