AccountId: 011433970860
ContactId: fe9fc659-d57e-4cde-a820-d653daaf15f0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218899 ms
Total Talk Time (AGENT): 107598 ms
Total Talk Time (CUSTOMER): 60516 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/fe9fc659-d57e-4cde-a820-d653daaf15f0_20250512T12:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII] and I'm trying to get some information on a patient, please.
[AGENT][POSITIVE] All right, I'm happy to help. Uh, do we have a policy number?
[CUSTOMER][NEUTRAL] Yeah, it is.
[CUSTOMER][NEUTRAL] D as in dog, 459-038-41.
[AGENT][NEUTRAL] All right. No, I unfortunately can't pull the patient with that number. Do you see anything on there that says like certificate number?
[AGENT][NEUTRAL] Or in hospital number?
[CUSTOMER][NEUTRAL] Let me go back up.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] If not, we can check by name.
[CUSTOMER][NEUTRAL] Yeah, it's uh it's yeah I got it it's 02044285.
[AGENT][POSITIVE] Perfect. That sounds right here. Thank you.
[AGENT][NEUTRAL] All right. And then if I could get the patient name and date of birth, please?
[CUSTOMER][NEUTRAL] Yeah, it's for [PII]. Birth date is [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] All right. How can I help with this? Did you need benefits, eligibility, check claim?
[CUSTOMER][NEUTRAL] Yeah, I need both, yeah, but benefits and eligibility, please.
[AGENT][NEUTRAL] OK, no problem. So patient is active. Effective date on here is [PII].
[AGENT][NEUTRAL] And is patient being seen for like an office visit or?
[CUSTOMER][NEUTRAL] Um, he's gonna be having a screening colonoscopy.
[AGENT][NEUTRAL] OK, let me see what benefits are in here for this.
[AGENT][NEUTRAL] OK, so the patient's plan is a limited benefit plan. It's called the Hospital indemnity, so you know it pays a set amount depending upon what they're being seen for. Um, it looks like any type of surgery in a hospital, outpatient facility, or free standing center, um, Benefit max is 2000 per day, maximum of 1 day per calendar year per covered person.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then any sort of outpatient treatment in a physician's office, um, that benefit amount is $100 per day maximum of $4 per calendar year.
[CUSTOMER][NEUTRAL] OK, so I'm assuming he doesn't have no deductible out of pocket or cover insurance.
[AGENT][NEGATIVE] Right, yeah, that would not be applicable here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All [PII] then. Uh, do you spell your name with an [PII] or just [PII]?
[AGENT][NEUTRAL] No, I have an [PII] at the end. It's [PII]
[CUSTOMER][NEUTRAL] OK, OK, and do you have a reference for our call, please?
[AGENT][NEUTRAL] Yeah, absolutely. Call references my name with the initial to my last name and then today's date. My initial to my last name is [PII].
[AGENT][NEUTRAL] And then today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. All right, sounds good. Thank you for your time. Have a great day.
[AGENT][NEUTRAL] You too bye bye.