AccountId: 011433970860
ContactId: 692e6911-70a6-4dbd-afd8-ca50a0afae11
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 205550 ms
Total Talk Time (AGENT): 105506 ms
Total Talk Time (CUSTOMER): 74783 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/2025/01/29/692e6911-70a6-4dbd-afd8-ca50a0afae11_20250129T15:34_UTC.wav
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[AGENT][NEUTRAL] Morning, thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hey, I just need help checking the statuses of a few claims and then I guess eligibility first for the same patient.
[AGENT][NEUTRAL] OK, go ahead and give me your name and the member's policy number please, ma'am.
[CUSTOMER][NEUTRAL] My name is [PII], and then his policy number, give me one second.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I'm pulling up his card, it is.
[CUSTOMER][NEUTRAL] Um, 02570010.
[AGENT][NEUTRAL] All right, [PII], thank you for that information. Now, while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for that information. Now what's your patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII] and then date of birth, [PII].
[AGENT][NEUTRAL] Alrighty. Now you did say you want to check the status of a claim. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes please, but could we maybe check eligibility first because he might not even be eligible.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Well, let's see, you actually have a dental department, but let me see if I can. That's OK. This is uh what we call a hospital indemnity plan. So you're wanting to know if something is covered. Let me see if I can get over there.
[CUSTOMER][POSITIVE] Oh, OK. I'm sorry.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, give me just a second and see if I can.
[AGENT][NEUTRAL] My computer is super slow this morning, so just bear with me.
[CUSTOMER][NEUTRAL] You're fine.
[AGENT][NEUTRAL] I don't.
[AGENT][NEUTRAL] Let's see if I can get to it. Let's see.
[AGENT][NEUTRAL] What exact benefit are you needing?
[CUSTOMER][NEUTRAL] Uh, medical.
[AGENT][NEUTRAL] I mean, what for what exact service?
[CUSTOMER][NEUTRAL] Oh, it was for gastroenterology.
[AGENT][NEUTRAL] For an office visit or what was, what was done?
[CUSTOMER][NEUTRAL] Yes, there was an office visit and then another office visit and then I think he had an EGD, yeah, he had an EGD as well.
[AGENT][NEUTRAL] OK, what date of service was that on?
[CUSTOMER][NEUTRAL] The EGD was done [PII] of last year and then he had office visits in October and April of last year.
[AGENT][NEUTRAL] Yeah, he was not covered here until [PII]. Let me go and make sure he didn't flip to a different number though. Let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] No, he did not. His effective date on this hospital indemnity plan here at APL was [PII], so he was not covered in any of those dates. So no, ma'am, he would not have any benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's what I was checking for.
[AGENT][NEUTRAL] OK. Well, yes, ma'am. Is that all that I can help you with?
[CUSTOMER][POSITIVE] That was it. Thank you so much for all your help.
[AGENT][POSITIVE] Well, yes, ma'am, [PII], and thank you for calling APL. You have a great rest of your day.
[CUSTOMER][NEUTRAL] You as well.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.