AccountId: 011433970860
ContactId: b5084015-8df4-44a2-bf4f-49e0c974a4a0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236880 ms
Total Talk Time (AGENT): 90126 ms
Total Talk Time (CUSTOMER): 48824 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/b5084015-8df4-44a2-bf4f-49e0c974a4a0_20250520T15:19_UTC.wav
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[AGENT][NEUTRAL] Morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name's [PII]. I am calling to get benefits for a patient to see if this coverage.
[CUSTOMER][NEUTRAL] Um, would actually cover what she's having done.
[AGENT][NEUTRAL] OK, [PII], you're just needing benefits. You do not need eligibility. Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, yes, I can help you with benefits. And what is your callback number, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] Policy number 02597080.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] You're in [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so how can I help you today with benefits on this limited benefit plan?
[CUSTOMER][NEUTRAL] So she is scheduled for a lead list pacemaker insert typically with the limited benefit plan we do as cash pay, but I always just call to check and see because sometimes cardiac stuff isn't even covered.
[AGENT][NEUTRAL] OK, so you said it was a needless pacemaker?
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am, being done outpatient hospital.
[AGENT][NEUTRAL] OK, so that was my next question. Outpatient hospital. OK, one moment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. So is this considered surgery?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so on this limited benefit plan, she does have an accident, a sickness surgery benefit, and the benefit amount would be $1500 per day, maximum of 2 days per calendar year per covered person.
[CUSTOMER][POSITIVE] Alrighty, that is the only information that I needed thank you so much.
[AGENT][NEUTRAL] OK. Well, you're very welcome and then one last thing, [PII], if you all end up filing a claim for this number once the claim has been processed, we do have a portal in which you should be able to check our claim status in and the website for that portal is located at [PII].
[CUSTOMER][POSITIVE] All right thank you so much.
[AGENT][POSITIVE] Well, you are very welcome. So again, thank you for calling APL and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you, bye-bye.