AccountId: 011433970860
ContactId: 1f357633-51ac-473d-8f14-61d95f3d9c3c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 488820 ms
Total Talk Time (AGENT): 172729 ms
Total Talk Time (CUSTOMER): 116208 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/1f357633-51ac-473d-8f14-61d95f3d9c3c_20250505T22:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi sorry, I was trying to get benefits for home health.
[AGENT][POSITIVE] OK, I can help you with benefits for a patient.
[AGENT][NEUTRAL] May I please get your name and your call back number and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Last initial [PII] and I'm calling from Premier Infusion and Healthcare Services.
[AGENT][NEUTRAL] OK, and Miss [PII], what is your callback number just in case the calls dropped I can call you back.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] My first name is [PII] with two Ts. Last name is [PII]
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And then what is [PII]'s policy number please?
[CUSTOMER][NEUTRAL] Um, I can really not tell through the card. Let me see, one second. It's really blurry.
[AGENT][NEUTRAL] Um, I can look it up. Let me see if I can find him by his name real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's a different last name, so maybe he'll pull in easily.
[CUSTOMER][NEUTRAL] Yeah it looks like 0 maybe I can guess anyways.
[CUSTOMER][NEUTRAL] 021 98 you got it?
[AGENT][NEUTRAL] I think I have him.
[AGENT][POSITIVE] Uh-huh, yes, I believe I have it pulled up now.
[AGENT][NEUTRAL] OK, I do have it pulled up and [PII] does have an active policy with us. His effective date is [PII].
[CUSTOMER][NEUTRAL] What, what type of uh plan is it that come like a commercial plan or a HM?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] This is a
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am. Um, this is just to verify his benefits. It's not a guarantee of payment. He has a supplemental insurance policy that's billed secondary to the primary. It helps with deductible, yes, it helps with deductible, co-pay and co-insurance.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's a supplemental plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] He has an inpatient benefit amount of $5000 per calendar year and then he also has an outpatient benefit amount per calendar day of $500 that goes towards deductible, co-pay or coinsurance.
[CUSTOMER][NEUTRAL] Uh huh
[CUSTOMER][NEUTRAL] Uh, do you mind holding on one second?
[AGENT][NEUTRAL] Yes, that's fine.
[CUSTOMER][NEUTRAL] Hold on one second.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Is this considered a uh um Medicare supplemental plan?
[AGENT][NEUTRAL] Uh, it's a supplement that's, um, secondary to whoever his primary insurance is.
[CUSTOMER][NEUTRAL] OK, so it's not considered a Medicare supplement, it's just supplemental to his insurance is what you're seeing.
[AGENT][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, one second.
[CUSTOMER][NEUTRAL] OK, one second.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] What other insurance do you guys have listed for this patient?
[AGENT][NEUTRAL] Let me see if we have his primary listed.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And you said this is called American Life Company?
[AGENT][NEUTRAL] American Public Life.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, he has Cigna.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, one second.
[AGENT][NEUTRAL] Uh, his insurance, his primary is, uh, through his group.
[AGENT][NEUTRAL] And this uh supplemental insurance is also through the group.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hold on 1 2nd.
[CUSTOMER][NEUTRAL] I'm pulling up a template one more minute.
[AGENT][POSITIVE] OK. Take your time.
[CUSTOMER][NEUTRAL] And you guys are considered the secondary, correct?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you for being patient.
[AGENT][POSITIVE] Oh, you're welcome.
[CUSTOMER][POSITIVE] OK, I'm ready for the benefits. I'm sorry I was not ready for you.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I gave you the benefits, uh, well, let me give you the benefits now. I'm sorry, this is just to verify his benefits. It's not a guarantee of payment. He has an inpatient calendar year benefit amount of $5000 and an outpatient per calendar day benefit amount of $500.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So he has an out of pocket?
[AGENT][NEUTRAL] No, this policy helps with deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] And you did give me an effective date and his ID number. Would you be able to give that to me again?
[AGENT][NEUTRAL] Yes, ma'am. The effective date of the policy is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And his policy number is 219.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 842 9.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you said for the out of the outpatient is how much?
[AGENT][NEUTRAL] 500 per calendar day.
[CUSTOMER][NEUTRAL] So if it's outpatient it's 500 a day. OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Anything else?
[AGENT][NEUTRAL] No, that's it.
[CUSTOMER][NEUTRAL] Alright, one second, and what was your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII], and if I can go get um go ahead and have the initial of your last name and a reference number for today.
[AGENT][NEUTRAL] Yes, it's A and you can use my name in today's date for your reference.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Alright, thank you so much for your help.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Is that everything I can help you with before we go?
[CUSTOMER][POSITIVE] Yes you did thank you.
[AGENT][POSITIVE] All right, well you have a wonderful night and thanks for calling APL.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye ma'am.