AccountId: 011433970860
ContactId: 2175c6df-b807-4e02-a9f6-1709c82385c5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 307140 ms
Total Talk Time (AGENT): 103166 ms
Total Talk Time (CUSTOMER): 116668 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/2175c6df-b807-4e02-a9f6-1709c82385c5_20250611T15:00_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. I need to find out um some information. Um, I have, um, a test that's going to take place on Friday, and they're telling me that I have a $150 co-payment, and I believe that this card they gave me, gave it to me in conjunction with my actually AMed insurance card cause it's supposed to be like the secondary.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] Um, and when I, they called me and they're telling me that I have to pay the copayment, so I'm giving them this card, and they said they called you guys and um that you guys said that you guys do not, do not, um, cover for the test, the co-payment for the test that I'm gonna take.
[AGENT][NEUTRAL] Let's look at, it's a sleep study, OK.
[CUSTOMER][NEUTRAL] It's a sleep test.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][NEUTRAL] Uh, policy number here, uh.
[CUSTOMER][NEUTRAL] Would that be the uh payer ID number?
[AGENT][NEUTRAL] Mm, it should, yeah, it should be a certificate number. Maybe it says in hospital or outpatient cert number.
[CUSTOMER][NEUTRAL] A group number.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] So this will be an uh outpatient, so 02587.
[CUSTOMER][NEUTRAL] 22
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] M as in Mary. L as in Larry. 8.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] That's the outpatient benefit certificate. Mhm.
[AGENT][NEUTRAL] OK. And then let me just verify your name and date of birth, please.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And then lastly, I just need to verify your address and email, please.
[CUSTOMER][NEUTRAL] My home is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You got it?
[AGENT][POSITIVE] Yeah, I got it here. Thank you. I see.
[CUSTOMER][POSITIVE] OK, perfect. OK.
[AGENT][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. So it's not gonna cover like an at-home sleep study, unfortunately. Um, all of your outpatient benefits are, um, have to be incurred in a, um, outpatient facility, um.
[CUSTOMER][NEUTRAL] Where
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEGATIVE] So it doesn't look like it is, it's not gonna cover that, unfortunately.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][POSITIVE] Great. So, and that's $150.
[CUSTOMER][NEUTRAL] Ouch.
[AGENT][NEUTRAL] Yeah, so you're only.
[CUSTOMER][NEUTRAL] So is there, I mean,
[AGENT][NEUTRAL] Other option would just be to see if they're willing to set up, you know, payments with you or whatever, but unfortunately from what I can see in the policy certificate, it would be denied.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So how about um like when I go to the doctor's visit and I gotta pay the $40 co-payment, do you guys cover that?
[AGENT][NEUTRAL] Yeah, so your um,
[CUSTOMER][NEUTRAL] Like my primary.
[AGENT][NEUTRAL] Mhm. Yeah. So they can definitely um bill us for that. That looks like that's covered under the uh office treatment, yeah.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEGATIVE] No, no.
[CUSTOMER][POSITIVE] And my gynecologist too, when I go to my gynecologist's office, they treat that too. They, you accept the co-payment too.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, so, yeah, I mean, you can definitely always give any other physicians that you have this as your secondary to pick up anything additional also.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Anything else I can check on for you?
[CUSTOMER][POSITIVE] OK then thank you for your time. No, that'll be great that'll be it thank you bye bye bye.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Bye bye.