AccountId: 011433970860
ContactId: 8d5b6a82-0e5e-48b9-87f0-5726b6530d0a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 182130 ms
Total Talk Time (AGENT): 68420 ms
Total Talk Time (CUSTOMER): 68833 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/8d5b6a82-0e5e-48b9-87f0-5726b6530d0a_20250320T18:19_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name's [PII]. I'm calling from the University of Iowa and I'm just calling to see if a plan's active and to get a few benefits.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yeah [PII] and policy is 020064887.
[AGENT][POSITIVE] Thank you. Could you verify the patient's name and date of birth, and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Yeah, [PII] [PII].
[AGENT][NEUTRAL] This policy has been active since [PII] and it's currently active, and what benefits are you inquiring about?
[CUSTOMER][NEUTRAL] Um, let me just get to that screen here.
[CUSTOMER][NEUTRAL] Um, OK, will this plan reimburse the university directly?
[AGENT][NEUTRAL] Yes, as long as the assignment of benefits are signed.
[CUSTOMER][NEUTRAL] OK, what network is used to process the charges?
[AGENT][NEGATIVE] This is not, there is no network. This is a gap insurance.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, is there a limitation on, um, outpatient visits?
[AGENT][NEUTRAL] The member has outpatient benefits of $2000 per calendar year, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK, um, limitation on inpatient stays?
[AGENT][NEUTRAL] The member's policy has inpatient benefits of $4000 per calendar year.
[CUSTOMER][NEUTRAL] Um, limitation on labs or radiology charges.
[AGENT][NEUTRAL] Lab falls under the outpatient benefits once that $2000 is.
[AGENT][NEUTRAL] Me then there's no more benefits allowed.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, same with radiology.
[AGENT][NEGATIVE] Yes, the same as the nasty.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, emergency room.
[AGENT][NEUTRAL] Will fall on the outpatient benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Behavioral health?
[AGENT][NEUTRAL] Falls on the outpatient benefits for the treatment rider.
[CUSTOMER][NEUTRAL] All right, and then I just wanted to make sure we have the right claims address. Um, I've got [PII].
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, uh, call reference number for today?
[AGENT][NEUTRAL] We don't provide those, [PII]. However, you can use my name in today's date as a reference.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Yeah, I apologize I'm really bad at names. Can I have your name again?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much have a wonderful afternoon.
[AGENT][POSITIVE] You're welcome. Thanks for calling [PII]. Have a great day.
[CUSTOMER][NEUTRAL] You too bye.