AccountId: 011433970860
ContactId: fd937f21-f804-4a17-9ce3-5bc2bcbb7062
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 304450 ms
Total Talk Time (AGENT): 111119 ms
Total Talk Time (CUSTOMER): 129995 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/fd937f21-f804-4a17-9ce3-5bc2bcbb7062_20250417T13:16_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEGATIVE] Good morning [PII]. How are you? I was calling because I'm having a back and forth with my, um, OBG in regards to, uh, I'm pregnant and my prenatal is 100% covered by that, that's fine, but I have, uh, the labor costs. They're telling me that I have to cover my $6000 deductible and then the out the, the maximum out of pocket kicks in, which makes no sense.
[CUSTOMER][NEUTRAL] Because I have a gap with you guys for $7900 which is my maximum out of pocket.
[CUSTOMER][NEUTRAL] I, I wanted to know how does that work?
[AGENT][NEUTRAL] OK. Do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have your policy number?
[CUSTOMER][NEUTRAL] Yes, give me one second.
[CUSTOMER][NEUTRAL] I'm gonna get this out of my wallet.
[CUSTOMER][NEUTRAL] OK policy number.
[CUSTOMER][NEUTRAL] What is that, like the group number? I do see that on my card.
[AGENT][NEUTRAL] It's um like the outpatient inpatient certificate number or something like that.
[AGENT][NEUTRAL] It'll be a 0102.
[CUSTOMER][NEUTRAL] The certificate.
[CUSTOMER][NEUTRAL] OK, I have in hospital and outpatient.
[CUSTOMER][NEUTRAL] In hospital is 024.
[CUSTOMER][NEUTRAL] 518
[CUSTOMER][NEUTRAL] 25
[CUSTOMER][NEUTRAL] ML 7.
[AGENT][NEUTRAL] And what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And can I verify your date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] And can I verify your address and email address, please?
[CUSTOMER][NEUTRAL] Email address is [PII] and my address, I recently moved to [PII], but I'm not sure if I still have [PII].
[AGENT][NEUTRAL] It is [PII]. Would you like me to change your address?
[CUSTOMER][NEUTRAL] I still
[CUSTOMER][NEUTRAL] Please, if you can help me with that one.
[AGENT][NEUTRAL] OK. Give me your new address again, please.
[CUSTOMER][NEUTRAL] New address is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And that is going to be
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the city is [PII].
[AGENT][NEUTRAL] P.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Times.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then, and what's the zip?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK. I got [PII].
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] OK, I'll get that changed for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Thank you, Mr. [PII], and you were wanting to know how the benefits work on this policy?
[CUSTOMER][NEUTRAL] Say that again.
[AGENT][NEUTRAL] You are wanting to know how the benefits work on this policy?
[CUSTOMER][POSITIVE] That is correct, yes, please.
[AGENT][NEUTRAL] OK, your effective date was [PII]. Any benefits given over the phone is not a guarantee of payment.
[AGENT][NEUTRAL] Now, um,
[AGENT][NEUTRAL] This policy does coordinate with your primary insurance.
[AGENT][NEUTRAL] Whatever your primary applies to your deductible, co-pay, or coinsurance only.
[AGENT][NEUTRAL] For outpatient we'll pay up to $2500.
[AGENT][NEUTRAL] For impatient, we'll pay up to 7900.
[CUSTOMER][NEUTRAL] 7900. OK, and that includes deductible, maximum out of pockets, copayments, and all of that.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] It only covers deductible co-pay or co-insurance.
[CUSTOMER][POSITIVE] Or co-insurance. OK. Perfect. That's what I, that's what I wanted to know. OK. Thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, that was it.
[AGENT][POSITIVE] Thank you, Mr. [PII] for calling APL. You have a good day and I'll get that address changed for you.
[CUSTOMER][POSITIVE] You too. Thank you. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.