AccountId: 011433970860
ContactId: c698805c-eed0-4560-9663-7ea83696732d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 301320 ms
Total Talk Time (AGENT): 103631 ms
Total Talk Time (CUSTOMER): 92593 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/c698805c-eed0-4560-9663-7ea83696732d_20250529T13:31_UTC.wav
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[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], I just got some questions for you. I got to go get a test done at the hospital, and I know they said, you know, I don't know if I can find you all on that also. So I need to check and see whether or not um they pay for anything like to help them deductible or anything.
[AGENT][POSITIVE] OK, I can help you with benefits. Can I get your name and a good callback number in case we get disconnected?
[CUSTOMER][POSITIVE] OK, I'm [PII] Last name is [PII]
[AGENT][POSITIVE] And a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And do you have the policy number?
[CUSTOMER][NEUTRAL] OK, it's um
[CUSTOMER][NEUTRAL] Um, 02485347.
[AGENT][NEUTRAL] Alright, let me check on that for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can I get you to verify your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your address and phone number that we have on file?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the phone number that we have on file is the one you're calling from?
[CUSTOMER][NEUTRAL] Yes, uh huh.
[AGENT][NEUTRAL] Let me pull up your policy real quick.
[AGENT][NEUTRAL] And you said you're getting testing done?
[CUSTOMER][NEUTRAL] Yes, it's uh uh uh it's, uh, yes, uh-huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's what you call it um.
[CUSTOMER][NEUTRAL] Uh, color gran, um, when they have to go through, you know, go looking I guess they're gonna go down and look at my stomach or something.
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] OK, let me put you on hold for 2 minutes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's a dry gram, ma'am, where you have to go in and look at, look down your stomach and, you know, I can't think of what you call it.
[AGENT][NEUTRAL] Like an endoscopy?
[CUSTOMER][NEUTRAL] It could be, uh, what do you call it, hologram.
[AGENT][NEUTRAL] OK, um, well, I do have your policy pulled up and I do want to remind you this is a secondary gap, so your primary insurance will have to show that they pay some benefits first, and we will need their um their uh explanation of benefits in this claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and this is also just a verification of benefits and not a guarantee of payment. You do have an inpatient hospital maximum of up to $3000 per calendar year.
[AGENT][NEUTRAL] And an outpatient benefit maximum.
[CUSTOMER][NEUTRAL] Mhm that's in.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, you have an outpatient benefit maximum of up to $500 per calendar day.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] So hopefully that helps. Um, you have a $0 deductible for in-hospital and outpatient services.
[CUSTOMER][NEUTRAL] But they only cover for outpatient $500.
[AGENT][NEUTRAL] $500 per day.
[CUSTOMER][NEUTRAL] Uh uh I'm talking my outpatient.
[AGENT][NEUTRAL] Let me see if that would be considered outpatient.
[CUSTOMER][NEUTRAL] Yes, I, I think more likely.
[AGENT][NEUTRAL] Because if you're getting
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] If you're getting any sort of diagnostic testing, it would be under your outpatient treatment. Um and that's $500 per day. So if you have to go in um on different days for services, it's $500 each time, and that's after your uh primary insurance pays part of it.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, that's why I need to sign, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[CUSTOMER][POSITIVE] OK, well that's my time. OK, thank you so much. You have a wonderful day.
[AGENT][POSITIVE] Alright, thank you for calling ATL. Have a great day.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye.