AccountId: 011433970860
ContactId: 001ebb79-9d2f-4ef6-abca-d6ce578233be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 313500 ms
Total Talk Time (AGENT): 147338 ms
Total Talk Time (CUSTOMER): 111091 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/001ebb79-9d2f-4ef6-abca-d6ce578233be_20250508T20:47_UTC.wav
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[AGENT][NEUTRAL] contact.
[CUSTOMER][NEUTRAL] Hey, this is [PII] and the last name is [PII]. Hello, am I audible to you?
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yes. Hi, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, this is [PII], and the last name first is [PII] calling from rendering facility for eligibility and benefits of a patient today. Can you please help me with that?
[AGENT][NEUTRAL] Yes, and I can help with eligibility and benefits. What's the policy number, please?
[CUSTOMER][NEUTRAL] Sure, ma'am. Just give me a second.
[CUSTOMER][NEUTRAL] The policy number is 024753887.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Mhm. Yes, ma'am. That just give me a second.
[AGENT][NEUTRAL] Yes,
[CUSTOMER][NEUTRAL] Um, the callback number is [PII].
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. Now, this policy has in and out of hospital benefits, and is there anything in particular that I can tell you about the policy? Outpatient, inpatient services?
[CUSTOMER][NEUTRAL] Ma'am, it is for.
[CUSTOMER][NEUTRAL] Durable medical equipment, CPAP supplies, ma'am. And can I have the plan type, please?
[AGENT][NEUTRAL] Yes, this is a secondary or gap insurance so they will have major medical and what we do is we'll take out.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Co-payment of coinsurance from their major.
[CUSTOMER][NEGATIVE] Ma'am, your voice is breaking out.
[AGENT][NEUTRAL] Yes, I'm sorry, can you, can you hear me better now?
[AGENT][NEUTRAL] Can you hear me a little better now that
[CUSTOMER][NEUTRAL] Yes, ma'am. I can hear you now.
[AGENT][NEUTRAL] Yes, the policy is a secondary or gap insurance, and it's meant to pick up the deductible.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Co-payment or co-insurance?
[AGENT][NEUTRAL] From the major medical
[AGENT][NEUTRAL] And so, is there anything in particular that I can tell you about the policy? Would you like to know about outpatient services?
[AGENT][NEUTRAL] Or inpatient service.
[CUSTOMER][NEUTRAL] Ma'am, can I know the primary insurance, please?
[AGENT][NEUTRAL] Uh, let me see if I can find that. Excuse me just one moment.
[CUSTOMER][POSITIVE] Sure, ma'am. Take your time.
[AGENT][NEUTRAL] It looks like your primary insurance is called Neighborhood.
[AGENT][NEUTRAL] Neighborhood insurance.
[CUSTOMER][NEUTRAL] Ma'am, can you please repeat that?
[AGENT][NEUTRAL] Yes, their primary insurance is, is, is neighborhood.
[CUSTOMER][NEUTRAL] OK, ma'am.
[AGENT][NEUTRAL] Insurance?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, ma'am. So you will be covering, you will be picking up the primary insurance fully, right? There is no deductible payment or co-insurance, am I right, ma'am?
[AGENT][NEUTRAL] That's, that's right. What we do is we pick up the deductible, co-payment or co-insurance.
[AGENT][NEUTRAL] And for outpatient services, outpatient hospital, yes, as well as inpatient.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, ma'am. Thank you for that. And can I have the call reference number, please?
[AGENT][NEUTRAL] My name is [PII]. The first letter of my last name is [PII], and we're gonna use that today's date as a reference. Is there anything else at all that I can help with?
[CUSTOMER][NEUTRAL] Yes, ma'am. I have one more doubt. Can you please clarify me with that?
[AGENT][NEUTRAL] Uh yes, how can I help? What is that number?
[CUSTOMER][NEUTRAL] Ma'am, it is for the same number. Uh, whether you follow the primary plans guidelines or you're not will follow that.
[AGENT][NEUTRAL] Well, we, we follow it. Yes, we do follow the primary care insurance, um, but we don't, uh, there's some things that we don't cover such as office visits.
[AGENT][NEUTRAL] But, but it is meant to complement the, the major medical.
[CUSTOMER][NEUTRAL] OK, ma'am. And the claim mailing address will be the crossover or just have any claim mailing address for this patient?
[AGENT][NEUTRAL] The claim, uh, address for us, uh, there's several ways to file a claim. Um, we have an online service center at [PII]. We have a PO box number at 248.
[AGENT][NEUTRAL] 950.
[AGENT][NEUTRAL] That is in [PII] City, [PII].
[AGENT][NEUTRAL] And our zip code is [PII].
[AGENT][NEUTRAL] 24
[AGENT][NEUTRAL] 8950.
[AGENT][NEUTRAL] You can also fax your claim into us.
[AGENT][NEUTRAL] At 877.
[CUSTOMER][NEUTRAL] OK, ma'am.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Is there anything else at all I can help you with?
[CUSTOMER][POSITIVE] Um, no, ma'am, not for today, and thank you for your assistance. Have a great day and stay safe and bye for now.
[AGENT][POSITIVE] OK, thanks for contacting. Thank you for contacting me.