AccountId: 011433970860
ContactId: f054c321-7cb2-430b-9fe5-7bfd304156ba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 215860 ms
Total Talk Time (AGENT): 93047 ms
Total Talk Time (CUSTOMER): 49160 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/f054c321-7cb2-430b-9fe5-7bfd304156ba_20250527T14:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, I'm calling with Doctor [PII]'s office. I'm trying to get benefits for outpatient surgery, outpatient hospital setting for the professional fee on a member.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes, I can look at those outpatient benefits for you. um I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] My name is [PII]. It's spelled [PII]
[AGENT][NEUTRAL] OK, thank you. And then, uh, [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, my direct line [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Uh, I have 02604421.
[AGENT][NEUTRAL] Alright, and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII], [PII] I'm sorry, [PII].
[AGENT][POSITIVE] Perfect. OK, thank you so much for verifying that. Alright, so for this policy is active, effective date was [PII].
[AGENT][NEUTRAL] And this is a limited indemnity medical plan.
[AGENT][NEUTRAL] So it pays a set dollar amount per covered procedure or office visit. If you'll give me one moment, I will take a look. You did say this was for outpatient surgery, correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. Uh, one moment, let me get that policy pulled up and check those benefits.
[AGENT][POSITIVE] OK, I appreciate your patience. Sorry, I kinda had to think about it there.
[AGENT][NEUTRAL] OK. So, outpatient surgery. Let's take a look.
[AGENT][NEUTRAL] Alright, of course I will let you know verification of coverage is not a guarantee of payment for.
[AGENT][NEUTRAL] So for this policy, I do not see any surgical benefits.
[AGENT][NEUTRAL] See.
[CUSTOMER][NEUTRAL] OK, no surgical benefits. OK.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] And I got hospital admission, confinement, emergency room. I don't see anything, any like there's no outpatient uh surgical benefits for this policy.
[CUSTOMER][NEUTRAL] OK, that's fine. Great, um, do you reference numbers for the call?
[AGENT][NEUTRAL] It would be my first name, last initial, and today's date and so my name is spelled [PII] Was there anything else I could help you with?
[CUSTOMER][POSITIVE] No, ma'am, that was it. Thank you so much for your help.
[AGENT][POSITIVE] Alright, of course, thanks for calling HPO. Have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.