AccountId: 011433970860
ContactId: e5600618-99d8-4ea2-b2b4-7c3f8837f03c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 406369 ms
Total Talk Time (AGENT): 169148 ms
Total Talk Time (CUSTOMER): 167273 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/e5600618-99d8-4ea2-b2b4-7c3f8837f03c_20250328T19:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. I am a, uh, recovered, uh, individual, and I need to see if a surgery is covered or what I need to do so they can get a hold of you.
[AGENT][NEUTRAL] Um, so the providers can get a hold of us to file the claim you mean?
[CUSTOMER][NEUTRAL] Yeah, they
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] To file the claim you mean?
[CUSTOMER][NEUTRAL] They just want
[CUSTOMER][NEUTRAL] Yeah, that, well, they wanna make sure that the, the, it's a, it's a surgery, it's gonna be covered. It's a hernia surgery. Can you look at my plan and see what is covered?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Sure, um, I can get that pulled up um and providers can call us just the same way that you are right now with the same phone number we do talk to providers all the time. um, what was your name?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] My name is [PII]. What was your name too?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And then [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. And then do you have your policy number?
[CUSTOMER][NEUTRAL] Uh, yeah, I do, um, bla ba ba.
[CUSTOMER][NEUTRAL] What is it, is it on my card member card? I know it's because I, I'm, I'm part of this mem this 9 degree benefits, and but then the, the hospital stuff is under you guys, so I don't, I don't know if it's a different part you want my social?
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, that might be easier. That's fine. We can do the social, yeah.
[CUSTOMER][NEUTRAL] Or my employee ID number, the social?
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, and then just gonna verify some information really quick. [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, I've got a different address for you.
[CUSTOMER][NEUTRAL] I mean, no, [PII]. I'm sorry, did I say [PII]?
[AGENT][NEUTRAL] Hmm, I've got a a different one and uh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, do you have that [PII]? Oh, that's an old address. I, I've moved. That was from a couple.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Sure we can get that updated. I'm sorry if you don't mind, yes please so I can go ahead and get that corrected.
[CUSTOMER][NEUTRAL] OK, do you want the new one?
[CUSTOMER][NEUTRAL] OK, yes, [PII]. That's weird because I do get mail from APL that's weird.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You might have a forward on it I don't know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that's weird. That was from a couple of years ago. That's weird.
[AGENT][NEUTRAL] Mm, OK, yeah, well, just for good measure.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. OK, the, the correct address is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Just the number [PII]?
[AGENT][NEUTRAL] OK, that was [PII]?
[CUSTOMER][NEUTRAL] So it's
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I will go ahead and get that updated. Uh, last thing I need is the email address we've got on file for you. uh, looks like it's a Gmail account.
[CUSTOMER][NEUTRAL] Yeah, integrity Credit DFW.
[AGENT][NEUTRAL] Yes sir, that's it. OK, thank you for verifying that. Alright, give me just a moment let me get that policy pulled up.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, bear with me just a moment.
[AGENT][NEUTRAL] OK. Um, so was this going to be uh an outpatient surgery?
[AGENT][NEUTRAL] Or will you have to be staying in the hospital for, OK.
[CUSTOMER][NEUTRAL] Correct, it's a.
[CUSTOMER][NEUTRAL] No, it's just an outpatient hernia surgery, 30 minutes.
[AGENT][NEUTRAL] OK. Is it going to be in a, uh, do you know if it's gonna be in a physician's office or in an actual, uh, hospital facility?
[CUSTOMER][NEUTRAL] No, actual hospital, actual hospital.
[AGENT][NEUTRAL] Got it. OK.
[AGENT][NEUTRAL] So for that benefit, I am showing that amount is $500 towards that surgical benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's it.
[AGENT][NEUTRAL] That's yes.
[CUSTOMER][NEUTRAL] So that's just for the procedure. What about anything as far as how to in the because it's on, it's an outpatient procedure. Is there anything for the hospital or is it $500 total?
[AGENT][NEUTRAL] Sure, I do see.
[AGENT][NEUTRAL] For the surgery, yes, so you do have a hospital admission benefit, but I, that's going to be more um.
[AGENT][NEUTRAL] Along the lines of confinement if you were to be stayed uh inpatient essentially.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So can I um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do I have, can I have, can I, can I have you call? Do I, because there's this banner the hospital she wants, she called me this morning trying to get a hold of somebody. Do I have her call you or can you do I give you her number and you have you call with them?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Um, I wouldn't be able to call unfortunately, bu[PII] they can absolutely call us. We might have been a bit busy this morning, but we haven't been near as much, um, so it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I just can
[CUSTOMER][NEGATIVE] I, I think they're trying to call. See, it's weird. I have this 90 degree benefits plan and then you guys cover the other so I think they try and call that number and it's a pain so I'll give them.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, it is very confusing, yes, so you can give them this direct number.
[CUSTOMER][NEUTRAL] Is this
[CUSTOMER][POSITIVE] I know, trust me.
[AGENT][NEUTRAL] Um, so yes, um, I don't know if this is the same number you called. Is it the [PII]? Perfect, yes, that's us, so yeah, you can give them that number.
[CUSTOMER][NEUTRAL] Trust me.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Just have the hospital they give that to the hospital coordinator or whatever and they can call and see it and so it's $500 and then the rest is just I'm responsible for.
[AGENT][POSITIVE] Yes, that's perfect.
[AGENT][NEUTRAL] Well, uh well, we don't say what's patient responsibility that would be up to them.
[CUSTOMER][NEUTRAL] Hospital. OK. OK.
[AGENT][NEUTRAL] Yes sir. Alright, was there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK, well, I'll
[CUSTOMER][POSITIVE] That'll do it. I'll give that number to her and and we'll go from there. OK, thank you.
[AGENT][POSITIVE] Alright, sounds good yes sir thank you I hope you have a great weekend.
[CUSTOMER][POSITIVE] Thank you, too. OK. OK. You too. Bye-bye.
[AGENT][POSITIVE] Thanks. Bye bye.