AccountId: 011433970860
ContactId: 0d91895b-6dfc-4588-87a9-4c1d8c1088a8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224869 ms
Total Talk Time (AGENT): 86606 ms
Total Talk Time (CUSTOMER): 115663 ms
Interruptions: 1
Overall Sentiment: AGENT=2, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/0d91895b-6dfc-4588-87a9-4c1d8c1088a8_20250401T19:21_UTC.wav
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[CUSTOMER][NEUTRAL] Oh. True.
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] at Baptist Primary Care in [PII]. I just want to ask a few questions. A patient, um, or one of your beneficiaries, um, brought us in their insurance card today, and I just had a few questions for you.
[AGENT][NEUTRAL] OK [PII], I can help you. Um, what's your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Uh, yes, it is 0257988889.
[CUSTOMER][NEUTRAL] I'd be
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Um, it's [PII]
[AGENT][NEUTRAL] And the date of birth.
[CUSTOMER][POSITIVE] Oh, that's a good one. Hold on one second, um, let me see if I can pull it up real quick for you.
[CUSTOMER][NEUTRAL] Well, he'll probably do
[CUSTOMER][NEUTRAL] Let's see, his birthday is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][POSITIVE] OK, and how can I help you today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So this plan because he told us he's a um self employed um I guess truck driver who is the payer or let me ask this first, is this for medical like if he can come to the doctor's office or is this hospital only?
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] So this is a hospital indemnity plan. um, it's not like a major medical it's like a supplemental policy so basically it has a list of things that it it has a dollar amount that it'll pay out for so there's no network we don't coordinate benefits or anything like that. Um, are you with the doctor's office? Is that what kind of benefits you'd be looking for? OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Yeah, yeah, he's, it's primary care and he's being seen today and he presented this card and we didn't have it loaded in our computer because it's something that we're not, we would normally take uh we're trying to figure out that we have self pay or is this something that would cover his business where we could bill it for him.
[AGENT][NEUTRAL] OK, so, um, so let me, I'll quote you the benefits. It's not a guarantee of payment, just a basic outline of the policy for physician's office visit. The way this policy works is it will pay $75 per day to a max of 6 days per calendar year. So it's gonna, whatever the bill charges are, we will pay $75. That's the max that it pays for physician's office visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Towards is all OK and who, who is the payer through this? Is it APL of American Public Life is that actually who the payer is?
[AGENT][NEUTRAL] Yes, and we have a payer ID too if you when you get ready to file a claim if you'd like to file electronically.
[CUSTOMER][NEUTRAL] Um, I'll go ahead and get that from you because I'll have to have someone put it in because this is kind of be new in our system. It's not in there. What is the payer ID?
[AGENT][NEUTRAL] Uh, payer ID is 60801.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then we've also got our claims mailing address and then a fax number if you need those.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, looks like, um.
[CUSTOMER][NEUTRAL] I got that on here and uh is the [PII] [PII] [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] [PII], OK, so I got that and um, OK, so it'll pay $75 towards his visit. OK, that's what we were trying to figure out what we were gonna do and how we can set it up in there for him to take care of him today so that's what I needed.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] OK, anything else I can help with? OK, well, thanks for calling.
[CUSTOMER][POSITIVE] Thanks for your help today.
[CUSTOMER][POSITIVE] No ma'am I appreciate it.
[AGENT][POSITIVE] Thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Thank you thanks bye bye.
[AGENT][NEUTRAL] Bye.