AccountId: 011433970860
ContactId: 359d78eb-1ba1-41c2-a7e5-c569501d7192
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 182699 ms
Total Talk Time (AGENT): 61409 ms
Total Talk Time (CUSTOMER): 83515 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/359d78eb-1ba1-41c2-a7e5-c569501d7192_20250213T17:37_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] [PII], hi, my name is [PII]. I'm calling from a, uh, doctor's office in [PII]. I was just informed by a patient of ours who is going to be having surgery that he has the 2nd 2nd policy after his primary policy.
[CUSTOMER][NEUTRAL] And I was wondering if you could tell me how that works.
[AGENT][POSITIVE] OK, I'll be happy to assist with this benefits today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Uh huh [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Policy number.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] You know what, it doesn't have it on here has a uh group effective date.
[CUSTOMER][NEUTRAL] Mm, in hospital and outpatient benefit cert numbers but it doesn't have a.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's, give me, give me either one of those.
[CUSTOMER][NEUTRAL] OK, um, 01867002.
[CUSTOMER][NEUTRAL] M like mother L like Larry, number 8.
[AGENT][NEUTRAL] Thank you for that and the patient's name and date of birth?
[CUSTOMER][NEUTRAL] His name is [PII] and his birthday is [PII].
[AGENT][NEUTRAL] Thank you for that. Information please be advised the verification of coverage is not a guarantee of payment, so we work in conjunction with his major medical. We are the supplemental gap policy, so all of his claims will first go to his major medical for processing. Once you receive those back, then you would send the claim and the EOB to us for processing his patient responsibility.
[CUSTOMER][NEUTRAL] OK, so I have to go ahead and take care of sending it out.
[CUSTOMER][NEUTRAL] And that would be a PO box 248,950.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, and what portion of it do you guys cover? Do you have a particular um.
[AGENT][NEUTRAL] Is it inpatient or outpatient?
[CUSTOMER][NEUTRAL] Did
[CUSTOMER][NEUTRAL] This is outpatient.
[AGENT][NEUTRAL] And outpatient where doctor's office, ER urgent care.
[CUSTOMER][NEUTRAL] Uh, ambulatory center.
[AGENT][NEUTRAL] OK, so that would be, that would fall under the outpatient and the per day maximum is $500.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] All right
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Was there anything else I can assist with today?
[CUSTOMER][NEUTRAL] No, do you have a reference number for the call?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right thank you so much.
[AGENT][POSITIVE] Thank you for calling [PII] you have a good day.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] OK