AccountId: 011433970860
ContactId: bea97121-10a6-4ac3-81f8-ce89a7828ee0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 181600 ms
Total Talk Time (AGENT): 83663 ms
Total Talk Time (CUSTOMER): 57536 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/bea97121-10a6-4ac3-81f8-ce89a7828ee0_20250507T18:30_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] with Oklahoma City Gynecology and Obstetrics, and I was wanting to check the benefits on this plan for a patient. She'll be having outpatient surgery.
[AGENT][NEUTRAL] OK, sure. I can assist you with benefits, Miss [PII]. And may I have um
[AGENT][NEUTRAL] A callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02567750.
[AGENT][NEUTRAL] Thank you one moment, let me put that information.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII] Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And let's see, this is one of our secondary supplemental plans to the major medical and we have an outpatient maximum of 5000 per covered person per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] It's a combined benefit.
[CUSTOMER][NEUTRAL] OK, so maximum out of pocket is 5000.
[AGENT][NEUTRAL] The maximum benefit is 5000. This is a combined inpatient, outpatient benefit, yes. And this is to help with the deductibles, co-payment, and co-insurance from the major medical.
[CUSTOMER][NEUTRAL] Maximum.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, um.
[CUSTOMER][NEUTRAL] What is for outpatient hospital? What is that benefit?
[AGENT][POSITIVE] It's a combined benefit, it's 5000.
[CUSTOMER][NEUTRAL] So if she owes 5000 then it drops to you, you guys pay the 5000?
[AGENT][NEUTRAL] Correct, we pay up to 5000. Mhm.
[CUSTOMER][NEUTRAL] Up to 5000.
[CUSTOMER][NEUTRAL] OK, alright, can I get a reference number for my call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes,
[AGENT][NEUTRAL] OK, sure. That's [PII]. That's in usual, it's [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] All right, thank you for your help.
[AGENT][POSITIVE] You're welcome and thank you for calling ATL. Have a good day, Miss [PII].
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Yeah