AccountId: 011433970860
ContactId: 38133797-4a9d-4de3-a2ae-fd3223dbd817
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241220 ms
Total Talk Time (AGENT): 102332 ms
Total Talk Time (CUSTOMER): 112585 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/38133797-4a9d-4de3-a2ae-fd3223dbd817_20250429T16:05_UTC.wav
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[AGENT][POSITIVE] Thank you for calling. Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Just gonna get them on the phone, OK.
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from the surgery center of Long Beach. I have a patient, um, that's checking in for surgery. He just provided us his gap insurance, um, policy, and it's, um, for surgery today, [PII].
[AGENT][NEUTRAL] I'm sorry, [PII], what is your callback number? I'm sorry.
[CUSTOMER][NEUTRAL] And so we just were
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] What is the policy number for the member please, [PII]?
[CUSTOMER][NEUTRAL] You can have a seat here
[CUSTOMER][NEUTRAL] The policy number is.
[CUSTOMER][NEUTRAL] 02606802.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can you call them in the back and tell them?
[CUSTOMER][NEUTRAL] So I'm trying to verify.
[AGENT][NEUTRAL] OK, verify the patient's name and date of birth.
[CUSTOMER][NEGATIVE] Oh sorry.
[CUSTOMER][NEUTRAL] Yes, his name is um [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. I know you're calling for outpatient benefits for surgery today, one moment.
[CUSTOMER][NEUTRAL] Um, and what was your name again?
[AGENT][NEUTRAL] My name is [PII]. My last initial is [PII]. Yes. For outpatient benefits, please note verification of benefits provided does not guarantee payment. We pay up to $2500 for the calendar year for covered services.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And I can check to see if anything has been used. One moment.
[AGENT][NEUTRAL] Nothing has been used. Uh, he has an effective date of [PII].
[CUSTOMER][NEUTRAL] OK, so you guys, so you guys will pick up his deductible, um, from Cigna, the 2500, um.
[CUSTOMER][NEUTRAL] Is that what you're saying?
[AGENT][NEUTRAL] We pay up to $2500 for coverage services um for all outpatient services, so we pay up to $2500 to help with his major medical deductible, co-pay, and our co-insurance.
[CUSTOMER][NEUTRAL] OK OK.
[CUSTOMER][NEUTRAL] OK, hold on, I'm just gonna have you speak with the because I just wanna make sure I fully understand this. Hold on.
[AGENT][POSITIVE] Awesome.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hi, may I have your name, please?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], yes, hi [PII]. I was explaining to you, [PII] that, hi, that this is a, um, we help with the major medical deductible, co-pay and co-insurance based on coverage up to the outpatient max of $2500 for the calendar year.
[CUSTOMER][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 2500 I think that's what his is actually and um so we don't.
[CUSTOMER][NEUTRAL] It's one of them where we bill you or we send the EOB to you. How do we send the claim?
[AGENT][NEUTRAL] You will first bill, thank you, [PII]. You will first bill the um his Cigna first and then once you receive the EOB from Cigna, you'll then send us the claim for processing.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so we should not collect that deductible then it goes to you.
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] What's the claim address? Is it the one on the card? I think I saw the ID.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, it is APL claims PO Box.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] 248,950. Oklahoma City, Oklahoma 73124.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] To for
[CUSTOMER][NEUTRAL] I was like, Oklahoma.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, I'm sorry, what was your name again?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] Oh, I think she has it right there. [PII], OK, is there any reference number for a call or just your name?
[AGENT][NEUTRAL] Just my name in today's state and I was telling her my last initial is [PII], yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] All right thank you.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. Have a great day bye.
[CUSTOMER][NEUTRAL] You too bye.