AccountId: 011433970860
ContactId: e1956e03-cec2-4304-9a09-b7a104d9d12e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 282160 ms
Total Talk Time (AGENT): 122377 ms
Total Talk Time (CUSTOMER): 77029 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/e1956e03-cec2-4304-9a09-b7a104d9d12e_20250509T16:29_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so, my name is [PII]. I'm calling from Western Surgical Group. I'm just trying to get some information from you regarding allowables and patient benefits.
[AGENT][NEUTRAL] [PII]. OK, sure. I can assist you with benefits, Miss [PII], and I'm sorry, I didn't quite catch the name of the surgical center or the surgical group.
[CUSTOMER][NEUTRAL] Western Surgical Group.
[AGENT][NEUTRAL] Western. OK, thank you. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And do you have the patient's policy number?
[CUSTOMER][NEUTRAL] I have 02585017.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, perfect. Thank you. All right. And what type of service is gonna be render, Miss [PII]?
[CUSTOMER][NEUTRAL] It's gonna be for outpatient surgery.
[AGENT][NEUTRAL] Is this gonna be a hospital or outpatient facility or is it considered an office?
[CUSTOMER][NEUTRAL] Um, probably a hospital.
[AGENT][NEUTRAL] All right. 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 this is one of our limited hospital indemnity policies, so it does pay a limited amount. Um, on this one, if it's in uh surgery.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] In a hospital, we cover up to 2000 and that's one time per covered person per calendar year. If it's a surgical center, then we cover 1000 and that's up to 2 per year.
[CUSTOMER][NEUTRAL] One second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, so,
[CUSTOMER][NEUTRAL] And in hospital procedures, is that what you said?
[AGENT][NEUTRAL] Yes, if it's, if the surgery takes place in a hospital, then we cover up to 2000. But if it takes place in an outpatient surgery center, then we cover 1000.
[CUSTOMER][POSITIVE] Sorry, I just wanna make sure I have everything.
[AGENT][NEUTRAL] OK, yeah, it's OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do you have the, do you have like the allowed amounts?
[AGENT][NEUTRAL] OK, well, this is not a major medical. This is just a limited policy. So those amounts that I just gave you, they're flat amount. So that is all it's gonna pay.
[CUSTOMER][NEUTRAL] OK. So then they don't, this patient doesn't have a deductible or out of pocket or anything like that?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm, no, there's no deductibles, co-payment or coinsurance under this policy, and there's no network.
[CUSTOMER][NEUTRAL] Mm OK.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Sorry, one second.
[CUSTOMER][NEUTRAL] Can I just get a reference number?
[AGENT][NEUTRAL] We don't have reference numbers. Now you can use my name in today state if you will.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The spelling or any other.
[CUSTOMER][NEUTRAL] What's your name?
[AGENT][NEUTRAL] My name is [PII]. That's [PII] [PII].
[CUSTOMER][POSITIVE] OK, thank you so much. I hope you have a good day.
[AGENT][POSITIVE] You, you as well, Mrs. [PII] and thank you for calling ATL. mhm Bye-bye.
[CUSTOMER][NEUTRAL] Mhm. Bye bye.