AccountId: 011433970860
ContactId: f065cec3-842f-47c2-86e3-dd9cbc35f6f0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 301920 ms
Total Talk Time (AGENT): 74733 ms
Total Talk Time (CUSTOMER): 110528 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/f065cec3-842f-47c2-86e3-dd9cbc35f6f0_20250521T13:20_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII]. I'm with Methodist Germantown Hospital in [PII]. I had a patient come in for an ultrasound, and, uh, he has the APL. I'm trying to verify, well, if I believe he said there's no network for this insurance.
[CUSTOMER][NEUTRAL] Uh, uh, he's, uh, like I said, he's having an ultrasound. I'm just need to kind of find out a little information about this, uh, insurance.
[AGENT][NEUTRAL] OK, and [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and may I have the policy number?
[CUSTOMER][NEUTRAL] I believe it's 025747772.
[AGENT][NEUTRAL] Thank you. Let me just re-verify that. I have that as 025747772.
[AGENT][NEUTRAL] One moment. I verify the patient's name.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] There was another.
[CUSTOMER][NEUTRAL] Uh, the patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. The patient shows effective as of [PII]. This policy shows active and you want to know what the benefits are for diagnostic. One moment, please, ultrasound, OK.
[CUSTOMER][NEUTRAL] Yes ma'am, at the hospital.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Bear with me. Let me get the policy pulled up. May I place you on hold, [PII], please? Thank you.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you so much for your patience, [PII]. I do not show a benefit for diagnostic under this policy.
[CUSTOMER][NEUTRAL] You don't show benefits for diagnostic, so the patient is gonna be considered self pay.
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEGATIVE] I'm not sure if this member has another insurance, but this policy does not cover for diagnostic.
[CUSTOMER][POSITIVE] Oh, wow.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Is there a reference number for this call?
[AGENT][NEUTRAL] We do not use reference numbers. You can use my name [PII] last initials [PII] and today's date. Anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] Mm, uh, I don't think so, honey, but you're saying he does not have for diagnostic testing, he has no he has no benefits, um, if he were to come in for a procedure or anything like that, does he have benefits for that?
[AGENT][POSITIVE] That's correct.
[AGENT][NEUTRAL] As far as the hospital.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] Um, he has a benefit for, well, if he was admitted into the hospital, he has a hospital confinement benefit, um, intensive care.
[AGENT][NEUTRAL] But no, ma'am, unless it's inpatient.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK, so he's OK, so it's basically because the little girl that verified his insurance first, she was trying to say he had some sort of United Healthcare which that was not active. They just didn't, uh, because I've gone to one source to verify that up under his name and date of birth and social and date of birth and could not pull up anything so, uh, apparently that was is inactive now and he knew that but the little girl to verify his insurance first.
[CUSTOMER][NEUTRAL] Apparently
[CUSTOMER][POSITIVE] Didn't care so all right well thank you for your help.
[AGENT][POSITIVE] You're welcome. I'm sorry about that, Ms. [PII]. You have a good day and thank you for calling APL.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mm bye.