AccountId: 011433970860
ContactId: 7e2ab39c-f438-45e6-a8a3-25c69e4e51a3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243500 ms
Total Talk Time (AGENT): 94710 ms
Total Talk Time (CUSTOMER): 110815 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/7e2ab39c-f438-45e6-a8a3-25c69e4e51a3_20250228T15:37_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling the ATL. This is. May I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. My name is [PII] and I'm calling because I'm a little confused on what kind of uh insurance policy I have with you guys, but it appears it doesn't cover anything and I need to know if I need to cancel this or not.
[AGENT][NEUTRAL] OK. Uh, do you have your policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Um, policy number is 02510922.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Sure that is area code [PII].
[AGENT][NEUTRAL] OK. And verify your, the date, uh, your date of birth, mailing address and email address, please.
[CUSTOMER][NEUTRAL] Sure, uh, date of birth is [PII]. Address is [PII], uh, yeah, [PII]. No, [PII]. Sorry. And you said, uh, email address?
[AGENT][NEUTRAL] Yeah it's fine.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Um, I believe you have [PII].
[AGENT][NEUTRAL] No, sir. It's a different iCloud address.
[CUSTOMER][NEUTRAL] Um, is it [PII]?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, well, the type of policy you have with our company is a limited medical indemnity plan, and you have benefits for inpatient facility, um, outpatient services like for sickness, such as an office visit or clinic or ER or urgent care, and you have a wellness diagnostic and a surgery benefit.
[CUSTOMER][NEUTRAL] OK, so you said outpatient sickness, correct?
[AGENT][NEUTRAL] Uh, for outpatient sickness, uh, that would be considered a physician's office, clinic, ER, or urgent care for sickness.
[CUSTOMER][NEUTRAL] Oh, OK, so I'm looking at these bills.
[CUSTOMER][NEGATIVE] That I received and it said that 0 amount was paid for outpatient sickness benefit.
[AGENT][NEUTRAL] What was the data service, or do you have the claim number?
[CUSTOMER][NEUTRAL] Uh, the claim number is 3554381.
[AGENT][NEUTRAL] OK. And those are sounds like you have an exclamation of benefits. It's not a bill, but it do show, looks like we paid $75 for that date.
[AGENT][NEUTRAL] Uh, give me one moment.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, sir. That's the max payable for an outpatient sickness. I know the outpatient sickness benefit rider is $75 per day and you have a total of $5 per year.
[CUSTOMER][NEGATIVE] So it sounds like this insurance is really not good then.
[AGENT][NEUTRAL] Uh, well, that's up to your decision, but there's just a limited amount of how much is paid for covered services though, but go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Because what I'm going.
[CUSTOMER][NEUTRAL] Yes, because what I'm going to the doctor for, it's, I have to go for the remaining of my life.
[CUSTOMER][NEUTRAL] Um, so yeah, it sounds like I just need to get Blue Cross Blue Shield or something or look into another plan.
[CUSTOMER][NEUTRAL] That will cover this.
[CUSTOMER][NEUTRAL] Because I'm looking at a handful of medical bills and only $75 has been paid out.
[CUSTOMER][NEGATIVE] I need to call my employee and let them know this. This is ridiculous. Alright, well thank you so much, ma'am, um.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yeah, I'll be looking to doing something about this insurance, yeah.
[CUSTOMER][POSITIVE] Thank you. I hope you have a good one.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Oh, you too. Thank you for calling APL.
[CUSTOMER][POSITIVE] Thanks bye bye.
[AGENT][NEUTRAL] Bye.