AccountId: 011433970860
ContactId: f25ea205-5143-4e81-a4c7-d935b21e2a85
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 462059 ms
Total Talk Time (AGENT): 183136 ms
Total Talk Time (CUSTOMER): 100917 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/f25ea205-5143-4e81-a4c7-d935b21e2a85_20250520T13:16_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. I was calling to see if the patient had active coverage for a procedure they're coming in for.
[AGENT][NEUTRAL] OK, so you're wanting to verify eligibility, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am ma'am.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] Then you need the member's ID number or the medical uh policy number?
[AGENT][NEUTRAL] Policy, policy certificate number.
[CUSTOMER][NEUTRAL] OK, 02513068.
[AGENT][NEUTRAL] Thank you one moment while I get the member's information pulled up, [PII].
[CUSTOMER][NEUTRAL] Y'all don't go by the number that starts with the letter D as in Delta?
[AGENT][NEUTRAL] Not here at APL, no ma'am. That is a 90 degree benefit number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And is that a medical plan? 90 degree?
[AGENT][NEUTRAL] That's a separate type of plan. Yes, ma'am.
[AGENT][NEUTRAL] For my PO mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so first off, any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so she is the subscriber on this hospital indemnity limited benefit plan, [PII], and this policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Now once the claim has been submitted and processed, we do have a portal here at APL that you should be able to check claim status in.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the website for our portal is located at [PII].
[CUSTOMER][NEUTRAL] OK. And are you able to look to see if a uh procedure is covered by this plan?
[AGENT][NEUTRAL] Is this for in OK and and again this is a limited benefit plan and is this for inpatient or outpatient?
[CUSTOMER][NEUTRAL] Outpatient
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, so on this limited benefit plan for accident and sickness surgery benefit for outpatient facility, the benefit is $500 per day, maximum of 1 day per calendar year per covered person.
[CUSTOMER][NEUTRAL] OK, so for instance, the colonoscopy, would that be covered?
[AGENT][NEUTRAL] Is that considered a diagnostic test?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, that would not be under this plan. No, ma'am.
[CUSTOMER][NEUTRAL] OK, and do you happen to have the number for the 90 degree member um provider number?
[AGENT][NEUTRAL] Uh yes ma'am, their phone number and this should be on the member's ID card as well, but it's [PII].
[AGENT][NEUTRAL] And it would be option 1 on that phone number option 1 is going to take you to 90 degree benefits and option 2 would bring you back here to APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Oh well you're very welcome. So would you like for me to connect you over or you needing to speak with him?
[CUSTOMER][NEUTRAL] Um, yes, could you connect me over please?
[AGENT][POSITIVE] I certainly can. So before I do that though, is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] Uh, no, ma'am, this is all.
[AGENT][POSITIVE] OK, [PII], well then, thank you for calling APL and I hope you have a nice day.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][POSITIVE] Uh yes, ma'am, and thank you too. So one moment, please.
[CUSTOMER][NEUTRAL] Thank you for calling IMA, a 90 Degree Benefits Company. Thank you for calling 90 Degree Benefits, the administrator for benefits in a card members. Please select from the following options to ensure you are directed to the appropriate party to answer your questions. For questions on IMA Mec Wellness, MVP plans, or COBR enrollment, please press 1.
[CUSTOMER][NEUTRAL] If you would like to participate in a quick survey after the call to rate your service with us, please press we're sorry, but all agents are currently unable to take your call. Please leave a.
[AGENT][NEUTRAL] Hi [PII], this is still [PII] at APL. OK, so it's going to an automated um answering that states that all agents are currently unavailable and it's asking to leave a voicemail, but I didn't wanna just drop you into the voicemail. So do you want to me to transfer you back so you can do that or do you wanna try to call them directly? It's one.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Whichever you prefer.
[CUSTOMER][POSITIVE] I'll just call. I'll just call. It's OK. Thank you.
[AGENT][POSITIVE] OK, well, you're welcome, [PII], again, thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank.