AccountId: 011433970860
ContactId: a0ba913e-88b1-4983-95a5-9db495dcbd01
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 403690 ms
Total Talk Time (AGENT): 173515 ms
Total Talk Time (CUSTOMER): 149326 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/a0ba913e-88b1-4983-95a5-9db495dcbd01_20250407T20:01_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling ATO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. Um, so I was just needing to know what are my benefits for, uh, insurance. I do have a doctor's appointment uh for ultrasound tomorrow, and I was told to call you guys to see how much a copay would be if I still uh follow through with that appointment.
[AGENT][NEUTRAL] OK, so you're wanting to get some benefit information on the plan that you have with APL is that correct?
[CUSTOMER][NEUTRAL] Correct, uh, the plan is in my dad's name, so I don't know if you guys can still give me information and everything on that or if you guys need to talk to him directly.
[AGENT][NEUTRAL] Yes, I
[AGENT][NEUTRAL] Um, if you're covered under this policy, once I verify several things with you first for security, I'll be, I will be able to answer your question.
[CUSTOMER][POSITIVE] OK, great.
[AGENT][NEUTRAL] All right, so first off, who am I speaking with, please?
[CUSTOMER][NEUTRAL] Uh [PII], uh uh spelled [PII] Last name [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] OK, thank you, Ms. [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the policy number, please?
[CUSTOMER][NEUTRAL] The policy number is gonna be 02513094.
[AGENT][NEUTRAL] OK, thank you. So give me a couple of moments please to get the policy information pulled up and then as as I explained, once I do, I will have to verify several things with you first for security. So just one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and Ms. [PII], also any information that I do provide for you will be verification of benefits and not a guarantee of payment. So first off, if you could please verify your father's name and date of birth and then your date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] What, what did you say? You need it first? I'm sorry.
[AGENT][NEUTRAL] Your dad's name and date of birth, his date of birth?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes, his name is [PII], uh same last name and date of birth, uh [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then your date of birth.
[CUSTOMER][NEUTRAL] And my date of birth, yes, ma'am. And my date of birth is gonna be [PII].
[AGENT][NEUTRAL] OK, thank you and the home mailing address.
[CUSTOMER][NEUTRAL] Uh, let me see.
[CUSTOMER][NEUTRAL] Give me one moment, please.
[AGENT][POSITIVE] Yes, ma'am. You're fine
[CUSTOMER][NEUTRAL] OK, the home address is gonna be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you and your dad's phone number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] His phone number is gonna be [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you very much for verifying that information with me. OK, so on this plan, Ms. [PII], you're going, you said you have an appointment tomorrow for, is it a visit?
[CUSTOMER][NEUTRAL] Uh, yes sir, it's gonna be for ultrasound.
[AGENT][NEUTRAL] OK, now, an ultrasound would not be covered under this policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You do have an office visit if you're, if they charge you an office visit, you do have office excuse me, office visit benefits under this plan, um, and that visit would be.
[AGENT][NEUTRAL] The benefit amount on here is $75 per visit with a maximum of 5 visits per calendar year. That's related to a sickness.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK. So it will only be
[CUSTOMER][NEUTRAL] 5 visits for the entire year and it's $75 each, like if the person is sick.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] That would be the correct. That would be what this plan would cover if approved. That's the benefit on this plan.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mhm. Yes, this is not major.
[CUSTOMER][NEUTRAL] OK, so, uh, but it does take care.
[AGENT][NEUTRAL] Yeah. I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] I'm, I'm sorry, go ahead.
[AGENT][NEUTRAL] No, I was just gonna say that this is not major medical insurance, so it only, this policy only pays specific dollar amounts for certain services per year.
[CUSTOMER][NEUTRAL] Oh, so,
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And an ultrasound is not a test that's covered under this plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So, um,
[CUSTOMER][NEUTRAL] Oh, that's my train of thought at first. Oh, OK. So does it take care of, um, just regular business like, let's say I just have a like have a bad, really bad cold or something, so I would take care of like a regular doctor's visit if even if it's not like as serious or.
[AGENT][NEUTRAL] Well, that would be if you
[AGENT][NEUTRAL] That would be sickness. I mean, that would fall under the category of sickness.
[AGENT][NEUTRAL] So that would be, you know, something that we could review under that $75 benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, got you. Alright, so yes ma'am, that's all I need to know if it was gonna um take care of it or anything like that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well, if that is, is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, no, ma'am. That'll be all.
[AGENT][POSITIVE] OK, Ms. [PII]. Well then, thank you for calling APO and I hope that you have a very nice rest of your day.
[CUSTOMER][NEUTRAL] Alright, you as well.
[AGENT][POSITIVE] Yes, ma'am. Thank you so much.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Alright bye bye.