AccountId: 011433970860
ContactId: 6e209f69-4eb0-4039-860f-97c786ee7c54
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 253440 ms
Total Talk Time (AGENT): 91716 ms
Total Talk Time (CUSTOMER): 67266 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/6e209f69-4eb0-4039-860f-97c786ee7c54_20250616T15:02_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I need to get benefits and eligibility for a patient.
[AGENT][NEUTRAL] OK. Happy to check benefits and eligibility. What is the policy number?
[CUSTOMER][NEUTRAL] 00099086801
[AGENT][NEUTRAL] OK, that's not coming up as a policy number. Do we have their name or social?
[CUSTOMER][NEUTRAL] Yes, I have both. Uh name is [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's try my name here. Give me just a second.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then if I could just get date of birth.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] So patient does have an active plan effective date on here is [PII], and I show the policy number as 99086801.
[CUSTOMER][NEUTRAL] OK, I, I don't know. I guess somebody decided to put that on there. OK, um, go ahead, um, so I, I'm looking for benefits and eligibility for facility. He's having, um, preventative colonoscopy.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me see here.
[AGENT][NEUTRAL] All right, so the patient's plan is like a limited benefit plan where it pays just a set amount depending upon what they're being seen for, so I'm just checking to see if I see anything.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Listed here. I appreciate your patience.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] No pun intended.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, so it does have colonoscopy listed. It shows an indemnity benefit amount of $218.
[CUSTOMER][NEUTRAL] So basically they pay a flat to 18 towards the procedure.
[AGENT][POSITIVE] Towards that procedure. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] All right.
[AGENT][POSITIVE] It does have also like some outpatient physician office visit benefit so it would pay like towards an off any sort of visit um then $65 for that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] OK. Well, I only represent the facility for the outpatient surgery, so that doesn't help.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well if I can get a reference number?
[AGENT][NEUTRAL] Yeah, call references my name with today's date. My name again is [PII], that's [PII], last initial [PII] like [PII].
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.