AccountId: 011433970860
ContactId: f296eb2e-d8c5-4ce4-b7a8-403090369824
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163360 ms
Total Talk Time (AGENT): 83769 ms
Total Talk Time (CUSTOMER): 75185 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/f296eb2e-d8c5-4ce4-b7a8-403090369824_20250213T19:03_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I just wanted to see if I can get a little bit of information. Um, I have a patient coming in for um outpatient surgery, and they have uh APL listed as a secondary, and I was just wondering if I can get some benefits information.
[AGENT][POSITIVE] I can certainly help with that. Whom am I speaking, please?
[CUSTOMER][NEUTRAL] My name is [PII]. That's [PII] Excuse me.
[AGENT][NEUTRAL] Thank you, [PII]. What is that policy number, please?
[CUSTOMER][NEUTRAL] I have 024583777.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] I have that as [PII], and date of birth I have is [PII].
[AGENT][POSITIVE] I do appreciate that. If I could have a callback number, please, in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yes ma'am. That's gonna be [PII] [PII].
[AGENT][NEUTRAL] Thank you. I'm just looking at this benefits now. So the policy went into effect on [PII]. It is active. Now you mentioned benefits for outpatient surgery. We will pick up the deductible, co-payment, or co-insurance for such a service up to $4500 per calendar year. Now I do need to tell you, [PII], that there is a $500 deductible that must be met on this policy before anything will be paid out.
[AGENT][NEUTRAL] So there is a deductible, um, $500 now for the calendar year, um, [PII], that has not been met.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, so that, that will be uh due first, but, um, yes, we do pick up the deductible co-payment or co-insurance uh outpatient surgery.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, did you need any more information like where to send your claim or?
[CUSTOMER][POSITIVE] Perfect. OK, so.
[CUSTOMER][POSITIVE] Uh, no, uh, let me just verify what I have really fast. Um, so you said that there is a $500 individual deductible, um, it has not been met yet, but once the deductible has been met, um, the insurance picks up everything else by 100%.
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][POSITIVE] Perfect. OK, so that's.
[CUSTOMER][NEUTRAL] First one was that um you mentioned uh 4500, is that like an out of pocket or is that just?
[AGENT][NEUTRAL] No, that's the benefit. Yes, that's the benefit. So we will pick up the deductible co-payment or coinsurance up to $4500 after that $500 deductible has been met.
[CUSTOMER][NEUTRAL] Like a
[CUSTOMER][POSITIVE] Oh, that's the benefit.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] I see, I see, OK, I'm just writing it down.
[CUSTOMER][NEUTRAL] Alrighty, I think that is all I needed really is there a reference number for the call?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII], and we're gonna use that today's date as our reference.
[CUSTOMER][POSITIVE] Sounds good thank you so much for your help today.
[AGENT][POSITIVE] OK, thanks for contacting APL. There's nothing else I can help with. Have a very good day.
[CUSTOMER][NEUTRAL] Sorry