AccountId: 011433970860
ContactId: 0bdc23a6-b3d1-408a-9753-48fae7e43d63
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 508709 ms
Total Talk Time (AGENT): 212945 ms
Total Talk Time (CUSTOMER): 181755 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/0bdc23a6-b3d1-408a-9753-48fae7e43d63_20250117T19:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yes, hi, good afternoon, [PII], right?
[AGENT][NEUTRAL] [PII] with a T.
[CUSTOMER][NEUTRAL] [PII], OK, I'm so sorry, um, so I'm so I'm calling to verify the, uh, coverage of the, uh, regarding a procedure that that I'm going to get done on the [PII]. Um, back in 20, uh, a couple of years ago, a couple of years I did a full, a full knee replacement.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh APO cover the, the deductible.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, they actually, when I call they say that yes, that I have um a maximum deductible I believe it was 7500 or something like that. I just wanna verify again that again that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That coverage is still um still good because I got to do now on my other knee, so I have to replace my other knee.
[AGENT][POSITIVE] Oh no. Oh goodness. OK. Yes, I can definitely check for you. Can I, can I get your name and your callback number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Yes, my first name is [PII] Last name is [PII] [PII]
[CUSTOMER][NEUTRAL] So, uh, my cell phone number is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and then, um Mr. [PII], what is your uh policy number, sir?
[CUSTOMER][NEUTRAL] Uh, would that be the, the payer ID? Is that what it is?
[AGENT][NEUTRAL] It might, it may say inpatient or outpatient or in hospitals or.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] OK, so this surgery is gonna be an outpatient. The number is 024.
[CUSTOMER][NEUTRAL] 65624 M L as Lima and uh number 8.
[AGENT][NEUTRAL] OK, let me pull that policy in for us real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK. Young, can you uh verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Can you verify your address, phone number and email address for me, sir?
[CUSTOMER][NEUTRAL] Yes, [PII]. Email is [PII].
[AGENT][NEUTRAL] OK, thank you very much for verifying that information for me. OK, so I'm gonna give you a different policy number because the one that you gave me is no longer active, you wanna make sure you use your active policy number?
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it is 1659.
[AGENT][NEUTRAL] 579.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] OK, and this is just to verify your coverage. Yes, sir?
[CUSTOMER][NEUTRAL] That is the uh that.
[CUSTOMER][NEUTRAL] I'm sorry, that policy is for the outpatient or is that just the policy in general?
[AGENT][NEUTRAL] That's your policy number for inpatient and outpatient.
[CUSTOMER][NEUTRAL] OK, got it. I need a new, well, when I'm done with you, but I do need a new card.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Um, I, I don't know if they, they have, you know, mailed that yet, but the one that I have is the old one with which the one that has this number that I gave you before.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, I will send you a new card. I'll order that for you sir today while we're on the phone um you're welcome OK and this is just to verify your coverage it's not a guarantee of payment you have um and you said it's gonna be outpatient procedure, is that correct?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, you have a benefit now of $7900 for outpatient. Uh, let me check to see if it covers surgery.
[AGENT][NEUTRAL] I'm going to pull your policy in real quick and I'll look at it.
[AGENT][NEGATIVE] And it's gonna be uh just a second while it loads because you know how computers can be slow sometimes.
[CUSTOMER][POSITIVE] Oh, I know, don't worry.
[CUSTOMER][NEGATIVE] Everything's slow. Even, even the cellphones nowadays are like super slow, I guess. We have so many people. Everybody's slow, everybody's connected, so everything's super slow, so I get it.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, that's true.
[AGENT][NEUTRAL] And I have to also read through it to see what your benefits are so it's gonna take me just a sec while I scan through your policy and see what it says about surgery.
[CUSTOMER][NEUTRAL] No rush.
[CUSTOMER][NEUTRAL] $7900 is what all the time that you need.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So for surgery,
[AGENT][NEUTRAL] You can have it done at, um, an outpatient surgery center.
[AGENT][POSITIVE] So that is good.
[AGENT][NEUTRAL] I want to just double check um what kind of facility are you going to?
[CUSTOMER][NEUTRAL] Um, well, it's, it's, it's a hospital, but it's an outpatient, uh.
[CUSTOMER][NEUTRAL] It's an outpatients, you know, surgery, but it's at the hospital.
[AGENT][NEUTRAL] Surgery. OK. OK.
[AGENT][NEUTRAL] OK, it also says hospital outpatient facility so that's good too so you you look like you're going to be OK um just I just wanted to double check that for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And make sure. So it looks like you're gonna be all right. Um, make sure that you give them that card though and um.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Or that new policy number. I'm ordering you your new card right now as we speak so that we can get that sent to you.
[CUSTOMER][POSITIVE] Awesome.
[AGENT][NEUTRAL] And you said it's on the [PII] of the month, so it should be there in time.
[CUSTOMER][POSITIVE] Great.
[AGENT][NEUTRAL] 9579. OK.
[CUSTOMER][NEUTRAL] OK, and I, and, and it's and it's.
[CUSTOMER][NEUTRAL] And it's $7900 that I get covered, right?
[AGENT][NEUTRAL] Right, up to $7900 and that helps with your deductible, co-pay or co-insurance.
[CUSTOMER][POSITIVE] Perfect. That's exactly what they're asking me actually 7900, so it's exactly it covers everything.
[AGENT][POSITIVE] Oh wow.
[AGENT][POSITIVE] That's, that's a blessing.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I know, I know, it is.
[AGENT][NEUTRAL] OK, well, is there anything else that I can help you with?
[CUSTOMER][POSITIVE] No, no, that, that'll be all. I just wanted to confirm that, that, that the, the coverage is still good and that, um, you know, I'll call them and tell them that. So perfect. I, I'll call him right now and let them know that, let them know and give them the policy number and hopefully, uh, you know, they'll take care of it. Alright, thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, sir. And you're welcome and I wish you the best of luck during your surgery, Jan. And we thank you so much for being an APL customer. You have a blessed weekend.
[CUSTOMER][POSITIVE] Will do thank you so much.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Mm bye-bye, sir.
[CUSTOMER][NEUTRAL] Bye bye.