AccountId: 011433970860
ContactId: b21f7f16-79d0-4c8d-8bc5-25a789f818ed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188789 ms
Total Talk Time (AGENT): 83120 ms
Total Talk Time (CUSTOMER): 68583 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/b21f7f16-79d0-4c8d-8bc5-25a789f818ed_20250430T19:20_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I need to check my benefits to see if you cover um an imaging uh procedure that I had done.
[CUSTOMER][NEUTRAL] And um, a radiologist, a diagnostic imaging center.
[AGENT][NEUTRAL] OK, what is your policy number?
[CUSTOMER][NEGATIVE] I don't have it. You're gonna have to look at that. I can't find the card anywhere.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No problem, one moment please may I have your last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and your first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is that with a [PII]?
[AGENT][NEUTRAL] Or
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] What is your date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and your call back number for disconnected please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you one moment.
[AGENT][POSITIVE] I appreciate that thank you. Now if you would also verify your mailing email address and I'm sorry, just your mailing and email address please.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, my email address is [PII], and my address is [PII].
[AGENT][NEUTRAL] OK, thank you very much. I was able to locate your policy and you want to know if we cover diagnostic testing done a diagnostic testing facility, is that correct?
[CUSTOMER][NEUTRAL] Right, um, American, um, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, when was it? Do you know if the claim has been submitted to APL for processing?
[AGENT][NEUTRAL] Or is it the upcoming.
[CUSTOMER][NEUTRAL] No, I haven't no I haven't sent it in. We just, I just wanna see if it's, if it, if I should send it in.
[AGENT][NEUTRAL] OK, um, as far as your benefits, um, please note verification of benefits provided does not guarantee payment. We pay up to $500 per day. It does cover diagnostic testing done in a diagnostic testing facility.
[AGENT][NEUTRAL] And it has been due to sickness or injury.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Not um wellness or preventative.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh, it has to be for an injury.
[AGENT][NEUTRAL] Sickness or injury.
[CUSTOMER][NEUTRAL] Oh OK, yeah, it was a calcium scoring without contrast.
[CUSTOMER][NEUTRAL] CT is a CT scan for calcium scoring on the heart.
[CUSTOMER][NEUTRAL] Without contrast.
[AGENT][NEUTRAL] OK, um, the claim can be.
[CUSTOMER][NEUTRAL] Wellness stands.
[AGENT][NEUTRAL] OK, um, once the claim has been submitted we can review then, but it has to be due to a sickness or an injury. It cannot be to due to, um, preventative or screening.
[CUSTOMER][NEUTRAL] OK, alright, well I just wanted to check.
[AGENT][POSITIVE] OK, yes ma'am. Anything else I can help you with?
[CUSTOMER][POSITIVE] That's it thank you.
[AGENT][POSITIVE] Thank you for calling APL. Take care bye.
[CUSTOMER][NEUTRAL] Mhm bye.