AccountId: 011433970860
ContactId: c661f275-d865-405c-991c-e2965acbfa7a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 257238 ms
Total Talk Time (AGENT): 107447 ms
Total Talk Time (CUSTOMER): 47663 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/c661f275-d865-405c-991c-e2965acbfa7a_20250306T15:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] calling from Southwest Fort Worth Endoscopy Center. I'm calling to get patients benefits. They're coming into our ambulatory surgery center for a screening colonoscopy.
[AGENT][POSITIVE] OK, thank you. I can help you with that information.
[AGENT][NEUTRAL] And [PII], what's the policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] It is 02506255.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] [PII] thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], last name is [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I'm sorry, date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Alright, so I'm that's OK. I'm showing a policy effective date of [PII], and I show the policy is currently active at this time and then under this policy.
[CUSTOMER][POSITIVE] Sorry about that.
[AGENT][NEUTRAL] Uh, screening colonoscopy isn't covered. If it's diagnostic, yeah, not the screening.
[CUSTOMER][NEUTRAL] Is not
[AGENT][NEUTRAL] Like for preventive or?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Alrighty, um, what is your name?
[AGENT][NEUTRAL] You'll use my name in today's.
[CUSTOMER][NEUTRAL] Oh, you
[AGENT][NEUTRAL] You'll use my name in today's date as reference for today's call. It's [PII], first initial of last name is [PII]. And any other questions, [PII] I can help out with today?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, if you could just go ahead and just give me their deductible and out of pocket information just in case.
[AGENT][NEUTRAL] OK, so there's not a deductible under this policy, of course the policy is secondary.
[AGENT][NEUTRAL] To the uh major medical policy, um, let's see, this is on an outpatient basis and so the maximum outpatient benefit is one moment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And in providing this information it's, it's just verification only it doesn't guarantee payment of a claim.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] For sure.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] Showing that the
[AGENT][NEUTRAL] The um inpatient and outpatient benefit is combined for a maximum of up to $3000 per covered person per calendar year of course that's for inpatient and outpatient collectively combined.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] And there's, there's no deductible under the policy.
[CUSTOMER][POSITIVE] Alrighty well I really appreciate your help thank you so much.
[AGENT][POSITIVE] Oh, you're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Uh bye bye.