AccountId: 011433970860
ContactId: 5f406134-6545-4b24-afde-7b26f4db56e1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203880 ms
Total Talk Time (AGENT): 112368 ms
Total Talk Time (CUSTOMER): 52160 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/5f406134-6545-4b24-afde-7b26f4db56e1_20250618T16:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I'm trying to figure out, find out my benefits, please.
[AGENT][POSITIVE] OK, I'm happy to check on benefits. Do you have a policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 02553200
[AGENT][POSITIVE] Thank you. One moment, please.
[AGENT][NEUTRAL] And then if I can get the first, last name and date of birth.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] First name, [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII] and then if you could please verify the address we should have on file.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] Thank you so much. All right. So it looks like this policy that you have with us is a secondary policy. It's meant to bridge the gap between your major medical and um hopefully you won't have any sort of large out of pocket cost.
[AGENT][NEUTRAL] It looks like your patient plan with us has.
[AGENT][NEUTRAL] In hospitals benefits and then it also has some outpatient benefits as well. So,
[AGENT][NEUTRAL] Looks like the maximum and hospital benefit on your plan is $500 per confinement.
[AGENT][NEUTRAL] Confinement is defined on the policy as being in the hospital for 18 hours or longer.
[AGENT][NEUTRAL] And then your outpatient benefits on here are $250 max per occurrence. What occurrence means on your plan is that the plan will pay out a maximum of $250 for what you're being seen for example, if you broke your ankle.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] We would only pay up to 250 for that broken ankle for the outpatient services. Nothing else would be additionally covered, so that's what that per occurrence means.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] So if I go and hit like say I got told something wrong and I need to feel for dominance or whatever, how much would they pay for that?
[AGENT][NEUTRAL] For what type of doctor?
[CUSTOMER][NEUTRAL] I have a toe foot.
[AGENT][NEUTRAL] OK, so if you're gonna be seen on an outpatient basis, then it's gonna cover up to $250 maximum for that toe.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and that doesn't show my life insurance or nothing on there.
[AGENT][NEUTRAL] Uh, this is just, yeah, your medical. Let me
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah, I just showed that you have a secondary medical plan with us. I don't see any life insurance with us.
[CUSTOMER][NEUTRAL] So who is my first one is this [PII]?
[AGENT][NEUTRAL] Ma'am, I have no idea.
[CUSTOMER][NEUTRAL] OK, alright, OK, alright, because just through my job that's why I was asking you.
[AGENT][NEUTRAL] Yeah, you would need to ask them. I, I'm not sure.
[CUSTOMER][POSITIVE] OK, alright, thank you.
[AGENT][POSITIVE] Mhm. You're welcome. Have a good day.