AccountId: 011433970860
ContactId: ded2e47a-4af5-4c41-9eee-25573ea8ddd8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 175869 ms
Total Talk Time (AGENT): 61418 ms
Total Talk Time (CUSTOMER): 67532 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/ded2e47a-4af5-4c41-9eee-25573ea8ddd8_20250519T14:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I have a question regarding coverage on my plan.
[AGENT][NEUTRAL] OK. Do you have your policy number?
[CUSTOMER][NEUTRAL] Yeah, 2203929.
[AGENT][NEUTRAL] OK. Could I verify your name and your date of birth?
[CUSTOMER][NEUTRAL] Sure, my name is [PII], [PII], my birthday.
[AGENT][NEUTRAL] And then just need to verify your address.
[CUSTOMER][NEUTRAL] Um, sure, [PII].
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, and then do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, and how can I help you today, Ms. [PII]?
[CUSTOMER][NEUTRAL] Well, my husband's going in for an echocardiogram, and I wanna see if there's any coverage for that.
[CUSTOMER][NEUTRAL] For that plan.
[AGENT][NEUTRAL] OK. Is it gonna be outpatient hospitals?
[CUSTOMER][NEUTRAL] Yeah, he's my clinic in our area.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me pull up your policy. Anything I quote is not a guarantee of payment. It's a basic outline of your plan.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, it looks like for outpatient hospital benefits, it pays up to $6000 per calendar year.
[AGENT][POSITIVE] And that's gonna be after your primary insurance has processed the claim. So whatever is left over, like co-insurance, deductible, co-pay, this policy will pick up up to $6000.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 6000. OK, so it could be like a test like that, right? It doesn't have to be like a hospital or anything like that.
[CUSTOMER][NEUTRAL] So those kind of tests are covered.
[AGENT][NEGATIVE] Uh, no.
[AGENT][NEUTRAL] So it, as long as it's performed in an outpatient hospital setting.
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Check one thing.
[CUSTOMER][POSITIVE] Great.
[CUSTOMER][NEUTRAL] Yeah, I got an estimate from them that was just my primary insurance, I would say I have like $1000.
[CUSTOMER][NEUTRAL] Um, patient responsibility, but that's not counting this insurance, so I guess I'll have to contact them so they can add that since we do have some coverage.
[AGENT][NEUTRAL] Yeah, just double checking and making sure that the diagnostic testing, yeah, yes, so yes, pay up to that 6000, yeah.
[CUSTOMER][POSITIVE] Yeah perfect.
[CUSTOMER][POSITIVE] OK perfect so I'll contact them and have that on. Great, thank you so much for clearing that up for me.
[AGENT][POSITIVE] OK, well thank you for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you bye bye.