AccountId: 011433970860
ContactId: 26d01f8d-36fd-43c5-b460-e9197b634010
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163649 ms
Total Talk Time (AGENT): 70747 ms
Total Talk Time (CUSTOMER): 83092 ms
Interruptions: 1
Overall Sentiment: AGENT=1.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/26d01f8d-36fd-43c5-b460-e9197b634010_20250225T17:14_UTC.wav
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[CUSTOMER][NEUTRAL] At the hospital getting a chest X-ray, but I'm working from.
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. Um, I have one of your members here. Um, she's gonna do a chest X-ray and she showed me that she has this insurance as a secondary plan. I just wanna know if it will cover her deductible.
[AGENT][POSITIVE] OK, I can definitely take a look into the policy for you. May I have the member's policy number and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Right, so the number is um 305, the phone number [PII].
[CUSTOMER][NEUTRAL] And the member ID it is 02348145 ML 7.
[AGENT][NEUTRAL] Thank you. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure, um, [PII], date of birth [PII].
[AGENT][NEUTRAL] Alright, thank you so much for verifying her information and all the information provided is a verification of benefits, not a guarantee of payment. Um, now, I am showing that this is the mailing policy, so we do pay towards the copay, deductible and co-insurance of coverage charges after primary.
[CUSTOMER][NEUTRAL] After primary, oh, OK, so you guys, they bill the primary insurance and then whatever they don't pay then you guys will pick it up, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. No, I don't want to say whatever they don't pay. We have our own benefits too, so, um, but.
[CUSTOMER][NEUTRAL] Uh, how much do you guys cover? You don't have that on.
[AGENT][NEUTRAL] Yes, I was getting ready to give you the max. Hold on one second.
[CUSTOMER][NEUTRAL] On the policy?
[CUSTOMER][POSITIVE] OK, OK great.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So the max for this policy is up to $500 per calendar day.
[AGENT][NEUTRAL] So it would only be up to that amount, not anything.
[CUSTOMER][NEUTRAL] Oh, so you guys only pay 500 like what you have in one day.
[CUSTOMER][NEUTRAL] Mm, and that includes deductible, co-payments, and coinsurance, but only 500, right? Maximum of 500.
[AGENT][NEUTRAL] Right. Mhm.
[CUSTOMER][NEUTRAL] Mm, OK, OK, um, can I have a reference number for this call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. Again, my name is [PII], first initial to my last name is [PII]. And just for my notes, can you spell your first name for me, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you for that. And was there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] No, that will be all thank you so much for your help.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Bye take care.
[AGENT][NEUTRAL] Bye bye.