AccountId: 011433970860
ContactId: 8a62c334-0111-41d4-b38f-dfc2a077fcb8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 508880 ms
Total Talk Time (AGENT): 214188 ms
Total Talk Time (CUSTOMER): 138547 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/8a62c334-0111-41d4-b38f-dfc2a077fcb8_20250505T14:33_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. I'm calling to find out, uh, I have scheduled a colonoscopy procedure for [PII].
[CUSTOMER][NEUTRAL] And I just wanted to know what I'm covered for, or if you do indeed cover.
[AGENT][NEUTRAL] OK, um, I
[CUSTOMER][NEUTRAL] And how much?
[AGENT][NEUTRAL] I can definitely look into your policy for you and see um how much can go towards it or towards the colonoscopy. Um, may I have your name and a good contact number just in case we're disconnected?
[CUSTOMER][NEUTRAL] OK. [PII], [PII].
[AGENT][NEUTRAL] Thank you. And may I have your policy number?
[CUSTOMER][NEUTRAL] Oh let me grab my one.
[CUSTOMER][NEUTRAL] Alright, um.
[CUSTOMER][NEUTRAL] Group name insured.
[CUSTOMER][NEUTRAL] 0228.
[CUSTOMER][NEUTRAL] 0800.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And I have you here, Mr. [PII], can you verify your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment and
[AGENT][NEUTRAL] For your um email, I'm sorry, can you um just give the email address on file?
[CUSTOMER][NEUTRAL] Oh, [PII].
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] So, for your um policy, you have the hospital indemnity policy with us. It does cover diagnostic and um diagnostic testing and medical imaging, um.
[AGENT][NEUTRAL] Under the
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Diagnostic test. Hold on one second.
[AGENT][NEUTRAL] Yeah, it doesn't specify colonoscopy, but I will go ahead and send it in, um, just in case because it it doesn't have to be specific to this list. There could be other tests that are considered, um, so the only way to like guarantee it would be to process the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But just in general for diagnostic testing, um, you're welcome. Your policy would pay, hold on one moment I'm trying to get to the dollar amount.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Um, up to $400 per day with a max of 1 day per calendar year. If an advanced study or follow-up test is needed, we will pay up to $100 per day, one day per year if it's covered.
[CUSTOMER][NEUTRAL] OK, so it's only 1 day, so it'll be 400 per day. OK. And uh that's all I needed to know I think and.
[CUSTOMER][NEGATIVE] Now I gotta find out how much they're gonna charge me.
[CUSTOMER][NEUTRAL] So that's all I wanted to know though.
[AGENT][POSITIVE] Alrighty, well, if you have any questions or if they need to verify any benefits with us, definitely give them our phone number and your policy number and we can go over uh benefits with your provider as well if you like.
[CUSTOMER][POSITIVE] So thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right. Was there anything else I can assist you with today? You're welcome.
[CUSTOMER][POSITIVE] Thank you very much.
[CUSTOMER][NEUTRAL] Uh, oh, what is today? Oh, it is Monday. Yes, there is. I need to make a payment.
[AGENT][NEUTRAL] OK, now for the payment, I will um have to get you over to group billing to make the payment over the phone. Do you mind if I get a representative for you?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, that would be great.
[AGENT][NEUTRAL] Alrighty, and hold on one moment for me, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Ferring
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. Can I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII] on the care team. How are you doing?
[CUSTOMER][POSITIVE] I'm good. How are you?
[AGENT][POSITIVE] I'm doing good. I have a member on the other line who needs to make a payment.
[AGENT][NEGATIVE] And you know what, they started asking questions in the chat and I didn't even hold on one second.
[AGENT][NEUTRAL] Do you need the um policy number? You know what? No, no, sorry, hold on. I need to send him to his group.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] I meant to check it before I call and they started asking questions in the chat and then I just went to calling y'all. So sorry, he, he does need to make a payment, but he needs to talk to his group. He's on the payment one.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] Alright, thank you. Sorry about that.
[CUSTOMER][POSITIVE] Alright, you're welcome no problem.
[AGENT][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. Um, so the payments, you would have to reach out to your HR department for that. It's still on payroll deduction, so it's coming through your HR department, so we don't actually take the payments out.
[CUSTOMER][NEUTRAL] Oh, wait a minute
[CUSTOMER][NEUTRAL] Oh no, I mean, uh, since I, uh, when I miss work, I have uh.
[CUSTOMER][NEGATIVE] And I, I, I had missed 3 weeks of work and I know I have to make one payment today. I made one last Monday and the Monday before.
[CUSTOMER][NEUTRAL] For my premium.
[CUSTOMER][NEUTRAL] So I, I could probably just hang up and call back or.
[AGENT][NEUTRAL] No, it, I mean, if you call back, we will still just direct you to the group. It just looking at the notes, you weren't speaking with us when you made the payment, but your policy is on payroll deduction, so your HR is taking the payment and then they'll send it to us.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] 00
[CUSTOMER][NEUTRAL] Yeah, but they don't have any income for those for the week of.
[CUSTOMER][NEUTRAL] Last week before last.
[AGENT][NEUTRAL] Right, so what I'm saying is instead of calling us to make the payment, you just need to call your HR. We can't take it because you're still set up with HR on their payroll. So they're going to take the payment from you when you call and then they'll pay us.
[CUSTOMER][NEUTRAL] And like
[CUSTOMER][NEUTRAL] Uh, cause I would
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] No, that would be it. Thank you.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] OK, you too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.