AccountId: 011433970860
ContactId: d87bd8d0-a4a8-4c5b-afdc-daceaf125446
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 396959 ms
Total Talk Time (AGENT): 132632 ms
Total Talk Time (CUSTOMER): 47884 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/d87bd8d0-a4a8-4c5b-afdc-daceaf125446_20250110T16:18_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I'm trying to check eligibility and benefits for a patient.
[AGENT][POSITIVE] Certainly I can help you with eligibility and benefits. Can I have your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And where are you calling from today Jessica facility name or provider?
[CUSTOMER][NEUTRAL] Uh, Christi Good [PII].
[CUSTOMER][NEUTRAL] It's outpatient hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And can I have a callback number in case we get disconnected please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what's the policy certificate or member ID please?
[CUSTOMER][NEUTRAL] 024950008
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And just give me one moment please [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And can I please have you verify a patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Just let you know it is a verification of coverage only and not a guarantee of payment.
[AGENT][NEUTRAL] I do show this policy is active. The effective date is [PII].
[AGENT][NEUTRAL] And you said it was gonna be for outpatient can you tell me what type of service?
[CUSTOMER][NEUTRAL] It's gonna be for a colonoscopy screening.
[AGENT][NEUTRAL] A screening colonoscopy, OK.
[AGENT][NEUTRAL] Just give me one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Now this policy is a limited medical hospital indemnity plan so it does have limited medical benefits.
[AGENT][NEUTRAL] OK, just give me one moment to search those.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Benefit for screening. OK, just one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] Just bear with me for just a moment. I don't see his policy here, so I'm searching here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Just one moment, sorry about that.
[AGENT][NEUTRAL] My system's hanging up so just bear with me for a moment.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Of course, sorry about that.
[CUSTOMER][MIXED] No, it's OK, mine's going a little slow today too.
[AGENT][NEUTRAL] Now [PII], that number you provided me [PII], can I contact you at that number?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And it goes direct to you?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] All right, can you give me a few minutes to uh figure out what's going on with my system and I'll give you a call back if that's OK.
[CUSTOMER][NEUTRAL] Yeah, that'll be fine.
[AGENT][NEUTRAL] And is that all you needed was the screening, uh, colonoscopy, correct?
[CUSTOMER][NEUTRAL] Yes ma'am, I, I just need to know if if they have a deductible out of pocket or co-insurance, but, and then you know if the screening is covered.
[AGENT][NEUTRAL] OK, so I do see a screening benefit, uh, when I was initially in there. So this policy again is limited medical hospital indemnity, so it does have limited medical benefits and it would be a straight benefit payment. There's no coinsurance or deductible, um, if the screening is covered, we would pay that benefit based on, uh, you know, that screening benefit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, but it is limited medical, um, it does not, uh, it's not a major medical insurance, so it doesn't have co-insurance or deductible, um, but I will give you a call back with that benefit amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Thank you for calling APL and sorry for the inconvenience, but I'll be contacting you soon, OK.
[CUSTOMER][NEUTRAL] No, no, you're
[CUSTOMER][POSITIVE] Yes ma'am thank you.