AccountId: 011433970860
ContactId: 1d391ee6-de02-42f5-86e3-89c9566fcf11
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258298 ms
Total Talk Time (AGENT): 156027 ms
Total Talk Time (CUSTOMER): 108985 ms
Interruptions: 6
Overall Sentiment: AGENT=1.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/1d391ee6-de02-42f5-86e3-89c9566fcf11_20250612T13:49_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATS. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] He's been checking every day. I have migrated, so, you know, yeah. Hello?
[AGENT][POSITIVE] Good morning. Good morning. Thank you for contacting ATR. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I am calling because I am currently pregnant and the way that my doctor is billing me for the pregnancy is that I have a payment every time I go see them.
[CUSTOMER][NEUTRAL] Uh, between I think it was $350 and $500 but they told me I can go ahead and file a claim with my gap insurance for those payments, so I just wanna confirm the process of how to do that and if that's a possibility.
[AGENT][NEUTRAL] Let's look at your policy, um, and see if we can do that. I'm sorry, I didn't catch your name.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], thank you. What is your policy number that we can look that up?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] The group number?
[AGENT][NEUTRAL] Well, it might be listed under the inpatient or outpatient benefits on your card. Do you have your card there with you?
[CUSTOMER][NEUTRAL] I do. Which one would I give you inpatient or outpatient?
[AGENT][NEUTRAL] Uh, either one of those two, it's, it's gonna get us to the same place.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I appreciate that. Thank you. And if I can verify your date of birth and the phone number, please. I just want to make sure I have the right, uh, policy.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] [PII] and then it should be [PII].
[AGENT][POSITIVE] Great, thank you. So we have your policy, um, your meddling policy. Now, for the um visits coming up with your doctor.
[AGENT][NEUTRAL] So what we will do with that, uh, we will pick up the deductible, co-payment or co-insurance for the treatment or procedures in the doctor's office up to $2000 per calendar year. Now that doesn't include the office visit co-pay, but if he does anything like draw blood or um if, if there's any sort of uh ultrasound or anything like that, that is gonna be covered under the outpatient benefits.
[CUSTOMER][NEGATIVE] What the hell.
[CUSTOMER][NEUTRAL] you're in your [PII].
[AGENT][NEUTRAL] Um, for your doctor's office, as you're making those visits each month, uh, during the course of your pregnancy.
[AGENT][NEUTRAL] Now, um, once you are ready to, to go to the hospital or wherever and deliver, we will pick up the deductible copayment or co-insurance up to $5000. But right now, um, you were asking me about your physician's office, and what we will do is we don't pick up the office of the co-pay, but we do pick up that treatment or procedures within the physician's office up to $2000 for 200 years.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh, it's $2000 per calendar year.
[AGENT][NEUTRAL] Yes, calendar calendar year, yes, for the um outpatient services, but it's fine for the once you're, uh, you go into the hospital.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, because my OBGYN, um, they said that they bill us I believe it's either $350 to $500 per visit that goes towards the hospital visit and everything else.
[AGENT][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] So I don't know, would that count towards the 2000?
[AGENT][NEUTRAL] OK, um, and, and if we
[AGENT][NEUTRAL] I'm not really sure. It depends on what he's charging me because is he doing anything else? Is it anything else besides just the office visit? Is he actually, um, are, are there uh tests that he's running, uh, or is he, um, is he doing any?
[CUSTOMER][NEUTRAL] It I think it's basic blood work and maybe ultrasounds sometimes.
[AGENT][NEUTRAL] OK, well then that's I would have them send that in because if it's if it's anything if we're doing looking at anything other than just the basic office co-pay.
[CUSTOMER][NEUTRAL] 4
[AGENT][NEUTRAL] That is certainly something that we would look at uh with a view to paying.
[AGENT][NEUTRAL] Um, so if, if they will send that into us, please, we will be glad to start looking at that and uh that should go towards your $2000 because it's a treatment or procedure within the physician's office.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] you want
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] Now, is there anything else at all that I can tell you about your policy? Um, and congratulations, by the way, uh, anything, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, I think that's it thank you so much.
[AGENT][POSITIVE] Thanks for contacting ATO have a great.
[CUSTOMER][NEUTRAL] I think that