AccountId: 011433970860
ContactId: ff28e817-ea82-404b-b702-53e8a9d4d42d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 152380 ms
Total Talk Time (AGENT): 87655 ms
Total Talk Time (CUSTOMER): 49180 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/ff28e817-ea82-404b-b702-53e8a9d4d42d_20250404T17:49_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], my name is [PII]. How are you doing today?
[AGENT][NEUTRAL] I'm fine, how are you?
[CUSTOMER][NEUTRAL] I'm good. I was just calling, um, I'm calling from a provider here in Baptist Hospital it's a medical facility for one of your members who has medical supplementary. I'd just like to know the benefits if possible.
[AGENT][NEUTRAL] I can help with the benefits. What is that policy number, please?
[CUSTOMER][NEUTRAL] So I have here.
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] 58
[CUSTOMER][NEUTRAL] 9500.
[CUSTOMER][NEUTRAL] ML 7.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] The name is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] I appreciate that. I just need a callback number, please, in the event that we're disconnected.
[CUSTOMER][NEUTRAL] It's [PII]. It's a direct line.
[AGENT][NEUTRAL] Appreciate that the policy went into effect on [PII]. It is active. Now for outpatient services, which includes treatment within a physician's office, cancer treatment, labs, durable medical, uh, any outpatient hospital setting, we'll pick up the deductible, co-payment, or co-insurance for a major medical up to $1000 per calendar day.
[AGENT][NEUTRAL] That is just a verification that benefits, not a guarantee of payment, um, but that is a per calendar day uh benefit.
[CUSTOMER][NEUTRAL] Can you tell me the ones for inpatient?
[AGENT][NEUTRAL] Uh, yeah, certainly. The inpatient is $2000 per occasion.
[AGENT][NEUTRAL] And again, just a verification, not a guarantee of payment.
[CUSTOMER][NEUTRAL] So 2000 per claim like per time that they.
[AGENT][NEUTRAL] Well, it's
[AGENT][NEUTRAL] Yes, it's it's called per occasion and all that really means is that um for uh each medical event, so um there'd be $2000 and she had a baby, she had $2000 and she's the hospital for a separate surgery, you know. Now, if it's the same event, um, if, if, yeah, then there's uh it's separated by 90 days, but that's, that's what it means is that it's $2000 per occasion. And again, I just have to say it, just a verification that again to your payment.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][POSITIVE] OK, all right then thank you so much [PII]. I just need the first is your last name and the reference number for the call.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] Yes, uh, the first initial and my last name is [PII]. We use that in today's date as a reference and if there's nothing else I can help with, and thank you for contacting APL. I hope you have a very good afternoon.
[CUSTOMER][POSITIVE] Thank you you too.