AccountId: 011433970860
ContactId: a9dd5338-8082-46fc-b357-32c13f4bb657
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 260298 ms
Total Talk Time (AGENT): 109701 ms
Total Talk Time (CUSTOMER): 79887 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/a9dd5338-8082-46fc-b357-32c13f4bb657_20250117T16:21_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm calling from Salinas Valley Memorial Hospital. I was looking to verify uh benefits for a patient, please.
[AGENT][POSITIVE] Oh sure, I can assist you with benefits, Miss [PII], and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Um, yes, it's gonna be.
[CUSTOMER][NEUTRAL] D as in David, 46401459.
[AGENT][NEUTRAL] Do you see a policy certificate number? It's gonna start with a 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] No, I don't see that on the insurance card.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] OK, I can do a name search. What's the spelling of the last name?
[CUSTOMER][NEUTRAL] It's uh [PII]
[AGENT][NEUTRAL] OK, and the spelling of the first name?
[CUSTOMER][NEUTRAL] Um, [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] May I have her date of birth?
[CUSTOMER][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] OK, thank you. I found her, Ms. [PII]. And um you said you're calling for benefits. What type of service is being rendered?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, it's gonna be an outpatient, um, surgery.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, and
[CUSTOMER][NEUTRAL] And it's gonna be done in a facility.
[AGENT][NEUTRAL] Outpatient facility or hospital?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. All right. And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And this is one of our hospital indemnity plan and let's see with this one.
[AGENT][NEUTRAL] OK, we cover a surgery in a hospital or outpatient facility. It is covered at $500 and that's one time per covered person per calendar year.
[CUSTOMER][NEUTRAL] I'm sorry, that was 500?
[AGENT][NEUTRAL] Yes, 500. This is a limited policy.
[CUSTOMER][NEUTRAL] OK. And it's, you said it was per surgery and that's one time a year?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so is, is there a deductible or out of pocket?
[AGENT][NEUTRAL] None with us, um.
[CUSTOMER][NEUTRAL] OK. And then is there a co-insurance?
[AGENT][NEUTRAL] No, this one doesn't have any deductibles, copayment or co-insurance because it's not a major medical. It's just a limited policy. So it just pays a flat amount which is the $500.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh OK, got it.
[CUSTOMER][POSITIVE] Perfect, thank you so much and then do you provide call reference numbers by chance?
[AGENT][NEUTRAL] We don't, um, you can use my name in today's date if you will. Do you need the spelling of my name or any other information, Ms. [PII]?
[CUSTOMER][NEUTRAL] Mm, yes, please.
[AGENT][NEUTRAL] OK, sure. That is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much for your help.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day, Miss [PII].
[CUSTOMER][POSITIVE] Thank you so much you too bye bye.
[AGENT][POSITIVE] Thank you. Thank you. You're welcome. Bye.