AccountId: 011433970860
ContactId: c44bb6bf-5fdf-42de-8d1c-37f5c0d34068
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 197220 ms
Total Talk Time (AGENT): 87638 ms
Total Talk Time (CUSTOMER): 68530 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/c44bb6bf-5fdf-42de-8d1c-37f5c0d34068_20250410T19:24_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling.
[AGENT][NEUTRAL] On APL this is
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, yes, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. I'm calling from USC Generals.
[AGENT][NEUTRAL] Yes, can you hear me?
[CUSTOMER][NEUTRAL] Yes ma'am, now I can. Can you hear me?
[AGENT][NEUTRAL] OK, I can hear you, yes. Mhm.
[CUSTOMER][NEUTRAL] OK. I'm calling from UNC General Surgery and I need to check benefits on a patient, please.
[AGENT][POSITIVE] OK, sure. I can assist you with benefits. And may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, ma'am, my name is [PII], and the phone number is [PII].
[AGENT][NEUTRAL] Thank you. And Miss [PII], may I have the patient's policy number?
[CUSTOMER][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] 02608942
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And his date of birth is [PII].
[AGENT][NEUTRAL] And what's the date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, perfect. Thank you. OK, and this is gonna be an outpatient surgery?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Uh, this is for uh office visit with a specialist.
[AGENT][NEUTRAL] Oh, OK, so it's an office visit. All right. OK. Let me go ahead and give you the benefits, and 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, which is a limited plan.
[AGENT][NEUTRAL] Um, with this one, we cover $75 per visit, maximum of 5 visits per covered person per calendar year.
[CUSTOMER][NEUTRAL] You said 5 visits per year.
[AGENT][NEUTRAL] Yes, 5 business per person per calendar year, correct. Mhm.
[CUSTOMER][NEUTRAL] OK, and that's January, so the end of December.
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you need any other information.
[CUSTOMER][NEUTRAL] So he doesn't have a deductible or?
[AGENT][NEUTRAL] No, this is not a major medical, so there's no deductibles, co-payment, and co-insurance. We pay a flat amount, which is that $75.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you check and see if our providers are in the network with this insurance?
[AGENT][NEGATIVE] There's no network on this one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you and what was your name?
[AGENT][NEUTRAL] You're welcome. My name is [PII]. That's [PII]. Last initial is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Thank you for calling APO. Have a good afternoon, Miss [PII].
[CUSTOMER][NEUTRAL] You too. Bye-bye.