AccountId: 011433970860
ContactId: 123faaec-23a4-494b-b1a7-501f7d257925
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 246419 ms
Total Talk Time (AGENT): 108246 ms
Total Talk Time (CUSTOMER): 131632 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/123faaec-23a4-494b-b1a7-501f7d257925_20250211T16:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] This is [PII].
[AGENT][NEUTRAL] Uh, [PII]
[CUSTOMER][NEUTRAL] Here
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from Blue Cross Blue Shield of Oklahoma. How are you this morning?
[AGENT][POSITIVE] I'm doing all right [PII] how are you?
[CUSTOMER][POSITIVE] I'm doing pretty good thanks for asking. I am calling in to get verification of coverage for mutual member. Are you able to assist me with that?
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Absolutely I can check to see if uh policy is active. uh, [PII], if you don't mind, can I first get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, let me get that and that phone number is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] I certainly do, um, that is, um, let me find that on my notes 02566459.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] Alright, and uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Certainly, uh, [PII], date of birth is [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that [PII]. Uh, so this policy is active. Effective date was [PII].
[CUSTOMER][NEUTRAL] No lapse in coverage, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Now is he is [PII] the policy holder?
[AGENT][NEUTRAL] Yes, he is the only member listed under this policy.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Now is this an individual or a group plan?
[AGENT][NEUTRAL] Uh, this is going to be through a group. Uh, we don't offer any individual policies.
[CUSTOMER][NEUTRAL] Right, OK, and could you give me the name of the group employer because I forgot to ask him.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Yes, um the name is uh [PII].
[CUSTOMER][NEUTRAL] OK, um, and then, no, uh, well, uh, let me double check the one I have is 245242.
[AGENT][NEUTRAL] Did you need that group number?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK, alright, awesome sauce. Now let's see what else, um, now when you all are now are you medical?
[AGENT][NEUTRAL] This is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after primary medical pays.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We are
[CUSTOMER][NEUTRAL] Secondary to us, alright, and then I'm double checking my stuff and he, I know he's already actively working still.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] There we go, I think I've got all my answers on there. Um, I just need a reference number so I can put it in my notes.
[AGENT][NEUTRAL] Sure, it would just be my first name, last initial, and today's date. Uh so my last initial is [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] Uh, not at this time, [PII]. Now, is there any information you're needing from me as primary insurance, uh, so that you have it for you all's records?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, ma'am, that's perfectly fine. Um, the biggest thing with this claim is or this um policy is of course just the understanding that it is very dependent on the primary uh medical. So if it's something that, you know, Blue Cross would not pay on this policy can't. So it's not like a true gap insurance, not something he could use instead.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, well, hopefully he understands that because that's, it's kind, so in other words you all are kind of similar to what we would be if um uh Medicare was primary and stuff because usually we, you know, most insurances follow what Medicare states, yeah.
[AGENT][POSITIVE] Yeah, it's, it's that supplement, yes, um, after the primary pays it's to help with that extra, yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] OK, yes ma'am, thank you very much. I will make note on there that you are a supplement and that if we don't cover it, you don't cover and things of that nature. Well, I do appreciate your assistance today, [PII]. You have a great rest of your day and a wonderful rest of your shift.
[AGENT][NEUTRAL] All right, yeah.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Absolutely.
[AGENT][POSITIVE] You too [PII], thank you so much.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Alright, bye bye.