AccountId: 011433970860
ContactId: 01d14d4f-44f1-4017-82f8-86bc44f08fe8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266820 ms
Total Talk Time (AGENT): 68498 ms
Total Talk Time (CUSTOMER): 102684 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/01d14d4f-44f1-4017-82f8-86bc44f08fe8_20250423T14:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling with Miami-Dade Ambulance. The patient gave us some claim information, and I just wanted to verify the info before we submit our bill.
[AGENT][NEUTRAL] OK, and I'm sorry, I missed your name. What was that?
[CUSTOMER][NEUTRAL] My name is [PII], last initial [PII]
[AGENT][NEUTRAL] OK, thank you, [PII]. And um do you have a good callback number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, and you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes, I have 243-293-2 for [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, and you were checking on, I'm sorry, I missed what you were checking on. Do you need benefits or eligibility?
[CUSTOMER][NEUTRAL] Yeah, just to make sure everything is correct before we submit the bill. Our data service is 527-24.
[AGENT][NEUTRAL] Uh, yes, I, I show the policy effective [PII].
[CUSTOMER][NEUTRAL] What type of um this is an ambulance bill that she has. What type of coverage is this? Um, I'm not familiar with American Public Life.
[AGENT][NEUTRAL] OK, so this is like a secondary gap policy. So after primary insurance pays it potentially picks up copay, deductible co-insurance for typically for like outpatient hospital, inpatient hospital services.
[AGENT][NEUTRAL] I can look and see if there's an ambulance benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, great. Thank you.
[AGENT][NEUTRAL] Um, this is not a guarantee of payment basic outline of the policy. Let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so for this policy, they have a $3500 per covered person per calendar year benefit.
[CUSTOMER][NEUTRAL] Bring.
[AGENT][NEUTRAL] And that
[AGENT][NEUTRAL] Yes, for ambulance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you said that does does it look like it's still is there still funds available for [PII] on that time?
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Uh, so it looks like she has used.
[AGENT][NEUTRAL] $1,519.21. So there are still some funds left.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Good, perfect. OK, it looks like her primary denied it. I'm the reason isn't listed yet, but I'm assuming they denied it for timely. If the primary denies for timely.
[CUSTOMER][NEUTRAL] I guess you probably wouldn't know, but do you know how that works if the primary denies, will the secondary automatically deny or does it still sometimes be considered?
[AGENT][NEUTRAL] It will, it will deny the primary has to consider the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and then let me just verify the address is [PII]. Is that correct or if you still submit a paper or a time?
[AGENT][NEUTRAL] Yes
[AGENT][POSITIVE] That's correct. Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. I think that's everything I needed. Thank you so much for your information.
[AGENT][POSITIVE] OK, thanks for calling APL. Have a good day.
[CUSTOMER][POSITIVE] You too thank you bye bye.