AccountId: 011433970860
ContactId: 32066178-643c-4c03-a868-691f052aa0bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 303320 ms
Total Talk Time (AGENT): 120436 ms
Total Talk Time (CUSTOMER): 89565 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/32066178-643c-4c03-a868-691f052aa0bf_20250131T20:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name's [PII]. Do you want my policy number to start with?
[AGENT][NEUTRAL] Yeah, like, go ahead whenever you're ready, [PII].
[CUSTOMER][NEUTRAL] Um, it's gonna be.
[CUSTOMER][NEUTRAL] 1153973
[AGENT][NEUTRAL] OK, let me pull this up here, just a moment.
[AGENT][NEUTRAL] All right, and then for security, can I just get your date of birth and address, please?
[CUSTOMER][NEUTRAL] Sure, it's [PII], [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, sir.
[AGENT][POSITIVE] Thank you so much. And is the AOL address, the Chevy [PII] still a good email for you?
[CUSTOMER][POSITIVE] Yeah, it's still good.
[AGENT][POSITIVE] Great. All right. How can I help today, [PII]?
[CUSTOMER][NEUTRAL] Hey, just a question, um, um, my wife is having a procedure.
[CUSTOMER][NEUTRAL] Next week
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] In the office, uh, in the, the.
[CUSTOMER][NEUTRAL] The doctor's office, uh, it's not a regular, it's not a regular office visit, it's a procedure for her back.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so would that qualify for the um.
[CUSTOMER][NEUTRAL] The uh co-payment or deductible if I have one.
[AGENT][NEUTRAL] Uh, let me take a look at your policy here and see exactly just to make sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Yeah what they explained to me was if it was like um.
[CUSTOMER][NEUTRAL] You know, urgent care, ER hospital, outpatient procedure, a procedure that's done, uh, you know, or procedures, not, not a regular doctor's visit, of course.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] Yeah, I was just trying to read under the outpatient benefits like what the cover charges were.
[AGENT][NEUTRAL] Um, so it does state like outpatient treatment in a hospital benefits payable under this for your out of pocket deductible co-payment or co-insurance would be outpatient treatment in a hospital emergency room without being considered inpatient, urgent care.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Outpatient surgery performed in a hospital outpatient facility or outpatient surgery center.
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Thank
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So yeah I mean I don't see anything in here that is saying under the exclusions as far as like any sort of office visit fee or deductible that you guys would have to pay would be excluded.
[AGENT][NEUTRAL] Um, it generally will state that specifically saying it's not covered. Um, so it looks like the outpatient benefit max for your plan is 4250 for the calendar.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, per day, yeah, per visit, yeah, yeah, yeah.
[AGENT][NEUTRAL] Looks like per per day, yeah, yeah.
[CUSTOMER][NEUTRAL] Yeah, it's nothing like that. It's I think uh it's gonna be a very mental, but I, I knew they I had some kind of coverage or benefit when it's not a doctor's visit, it's a procedure, so that's why I was.
[AGENT][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] So I'll have them. I'll give them both information so they can submit it and then if there's um if any questions I can go over it when you know it's done.
[AGENT][POSITIVE] Yeah, absolutely that's the easiest way to do it if they'll submit it for you on your behalf then yeah that takes care of everything for you and hopefully you won't have to do anything.
[CUSTOMER][POSITIVE] OK perfect that's all I needed thank you for your time.
[AGENT][POSITIVE] You're welcome, [PII]. Have a good one.
[CUSTOMER][POSITIVE] Take care.
[AGENT][NEUTRAL] Bye bye.