AccountId: 011433970860
ContactId: 2d6072c2-979f-40bc-9ed7-24e57843ae45
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 289239 ms
Total Talk Time (AGENT): 171684 ms
Total Talk Time (CUSTOMER): 100511 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/2d6072c2-979f-40bc-9ed7-24e57843ae45_20250130T19:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I was just wondering if I qualified for any benefit on my upcoming uh.
[CUSTOMER][NEUTRAL] Punning a surgery
[AGENT][NEUTRAL] OK, yeah, I could take a look at those benefits, see if that would fall under those um as for specific surgery. What was your name?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] And there [PII].
[AGENT][NEUTRAL] What was the last name, [PII]? I'm sorry.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] And then can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah [PII].
[AGENT][NEUTRAL] Alright, thank you. Do you have your policy number?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That is 02449602.
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] OK, I'm just gonna verify some information really quick. [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And can I get your mailing address?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect. The last thing I need is the email address that we've got on file for you. uh, looks like it might be through an employer.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Oh, our email?
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Yeah, I don't, I mean my personal email is that what you want?
[AGENT][NEUTRAL] Um, the email address that we have for you, um, it's at [PII].
[CUSTOMER][NEUTRAL] Probably, yeah, [PII], yeah, [PII], yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Got it. Just wanted to make sure that was correct. Appreciate you verifying all of that. OK, so in short, the way that this policy works, [PII], is it's very dependent on your primary medical. So as long as they are willing to pay or contribute to this surgery, then this policy can help. I imagine this is just going to be an outpatient surgery, is that right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Outpatient and my deduct I'm, I'm gonna be out of pocket about 3500 bucks or so.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so your outpatient benefit is $2000 max per calendar year and that could go towards, of course, deductible, co-pay or co-insurance, so it would help with that up to $2000.
[CUSTOMER][NEUTRAL] How do I go about using it so it OK, that's not a yearly deal.
[AGENT][NEUTRAL] So you can
[AGENT][NEUTRAL] It is yearly, um, that is a, it's every calendar year, so it's that $2000 per calendar year. um, what you can do, what I would always recommend doing anyway, anytime you go somewhere, any kind of provider for medical treatment, uh, present them with both of your cards, so whoever you have as your major medical and then this card as well, um, it is up to the provider whether they would file the claims on your behalf or not. Most of the time they will.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if there's any confusion they're more than welcome to give us a call as well we do talk to providers all the time and so we can kind of explain the plan and how they can go about uh filing claims. If not, if they just will not file the claim for you with us, you can still file those claims yourself.
[CUSTOMER][NEUTRAL] OK, so I already prepaid like 22,900. I'm gonna have this done on Monday.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Does that mean I can't use it or since I already paid for it?
[AGENT][NEGATIVE] No, not at all.
[AGENT][NEUTRAL] No, not at all. I would still, I would still give them this information. Yes, I would still give them this information, uh, because regardless, we have to have the explanation of benefits from your primary insurance before a a claim can be filed through this insurance.
[CUSTOMER][NEUTRAL] What do I do?
[CUSTOMER][NEUTRAL] Show him.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] See if they might help you out with that, see if they would help you out with it. I would definitely see if they would help you out with it first. If not, like I said, you can still file those claims. Um, I would try with them first though, and then if they won't, you can give us a call back and then we'll walk you through how you can do that.
[CUSTOMER][NEUTRAL] Well, so all I need to do then?
[CUSTOMER][NEUTRAL] Pardon me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK dokey.
[AGENT][NEUTRAL] Alright, did you have any other questions for me?
[CUSTOMER][NEUTRAL] That'll work.
[CUSTOMER][NEGATIVE] Uh, no.
[AGENT][POSITIVE] All right, well, thanks for giving us a call. OK, hope you have a great rest of your day. the surgery goes well.
[CUSTOMER][NEUTRAL] That's all I got for now.
[CUSTOMER][POSITIVE] Yeah, thanks for the info. Oh yeah, thank you.
[AGENT][POSITIVE] Yes sir, thank you.
[CUSTOMER][NEUTRAL] All right, bye bye.
[AGENT][NEUTRAL] Bye-bye.