AccountId: 011433970860
ContactId: 8c53f117-31d3-4d36-a2f0-65269f4b0bc8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 186199 ms
Total Talk Time (AGENT): 83440 ms
Total Talk Time (CUSTOMER): 65228 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/8c53f117-31d3-4d36-a2f0-65269f4b0bc8_20241231T21:19_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII]. I'm calling in regards to the patient to obtain benefits and coverage.
[AGENT][NEUTRAL] You said your name is [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] The policy number is 01788150 M as in Mary, L as in Larry, and the number 8.
[AGENT][NEUTRAL] And what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that information and you said that you're checking eligibility and benefits. Is this for service in a doctor's office?
[CUSTOMER][NEUTRAL] Uh, this is an outpatient facility for 2 MRIs, a mammogram, and an ultrasound.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Is the mammogram for screening or medical concern?
[CUSTOMER][NEUTRAL] Um, I see here she might have medical concerns just based on the fact that she's doing two MRIs.
[AGENT][NEUTRAL] OK. All right. Well just to let you know, the policy covers, uh, as a result of a sickness or an injury, so if it's COVID as well as it will not be covered. Um, I do show that the policy became effective.
[AGENT][NEUTRAL] [PII], it's currently active and the maximum outpatient benefit is up to.
[AGENT][NEUTRAL] $250 per calendar day.
[AGENT][NEUTRAL] And the information provided.
[CUSTOMER][NEUTRAL] 250.
[AGENT][NEUTRAL] 250 per calendar day, mhm.
[CUSTOMER][NEUTRAL] Per day?
[AGENT][NEUTRAL] And the information provided is verification, not a guarantee of payment. And did you have any other questions, uh, [PII]?
[CUSTOMER][NEUTRAL] OK, so for coverage it's just 250 because she mentioned it was 2000.
[AGENT][NEUTRAL] That's her inpatient benefit, so she have to be in the hospital for 18 hours or greater for the inpatient benefit.
[CUSTOMER][NEUTRAL] OK, so for outpatient it's 250.
[AGENT][NEUTRAL] Per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I please have a reference number?
[AGENT][NEUTRAL] Mhm. You'll use my name in today's date as your reference. [PII]. Any other questions I can help out with today?
[CUSTOMER][NEUTRAL] So, [PII]
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, thank you so much. I'm wishing you a lovely [PII]. Thank you.
[AGENT][POSITIVE] You too, [PII]. Thank you. Thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Thank thank you.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Uh, bye-bye.
[AGENT][NEUTRAL] Are you still there [PII]?
[CUSTOMER][NEUTRAL] Oh, yeah, so sorry. Bye.
[AGENT][NEUTRAL] Oh, it's OK