AccountId: 011433970860
ContactId: 439ae83a-13b9-4ecb-aa19-e53d98f84e55
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 417200 ms
Total Talk Time (AGENT): 228878 ms
Total Talk Time (CUSTOMER): 133334 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/439ae83a-13b9-4ecb-aa19-e53d98f84e55_20250128T17:03_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Good morning. Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] If you guys don't carry.
[CUSTOMER][NEUTRAL] Hi, I'm this is [PII] Advent Health Cardiology. I am trying to
[CUSTOMER][NEUTRAL] Find out what a patient exactly has.
[AGENT][NEUTRAL] OK, so you're wanting to verified type of benefits. OK, sure, I can help you.
[CUSTOMER][NEUTRAL] I've never heard of this
[CUSTOMER][NEUTRAL] Well, kind of sort of, um.
[CUSTOMER][NEUTRAL] I've never heard of this insurance. I really don't even know anything. Is this a disability insurance?
[AGENT][NEUTRAL] Well, let me get some information. I can tell you what the patient has. So, do you have a policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, let me make sure this is it. 682-303-068.
[AGENT][NEUTRAL] OK, uh, 20 many numbers. Uh, before I go any further though, what's your, what is your first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, and [PII], um, what's a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And what is the patient's name?
[CUSTOMER][NEUTRAL] Patient is [PII].
[AGENT][NEUTRAL] And what state does Miss [PII] live in?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, give me one minute, let me see if I can look at her.
[CUSTOMER][NEGATIVE] The card doesn't even say the name that she gave us for the name of the insurance, so I'm really confused.
[AGENT][NEUTRAL] OK. OK, let me see. What, what, what, uh what city does she live in?
[CUSTOMER][NEUTRAL] So let me get her hold on.
[CUSTOMER][NEUTRAL] She lives in [PII].
[AGENT][NEUTRAL] OK. Do you happen to have a social security number?
[CUSTOMER][NEUTRAL] Mm let me check here [PII].
[AGENT][POSITIVE] OK, thank you. Give me just a few more minutes.
[AGENT][NEUTRAL] And what is her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. Uh, what this policy is, it's a hospital indemnity policy. Um, it is a supplemental policy. It's not like it's a major medical, um, there's no pre-approval, no, um, contracts with this policy. Um, it has like an indemnity amount of coverage services.
[AGENT][NEUTRAL] Um, and let me pull this up. Let me see what outpatient.
[CUSTOMER][NEUTRAL] OK, well you said it's a supple you said it's a supplemental. She has, she's on disability.
[CUSTOMER][NEUTRAL] She doesn't have a Medicare card. We have a, I'm gonna make sure it's not even the same number that.
[CUSTOMER][NEUTRAL] What number did I give you? Um.
[CUSTOMER][NEUTRAL] OK, so, yeah, I mean, I have an insurance ID number for her office of disability and determinations.
[AGENT][NEUTRAL] OK. Well, this has nothing to do with Medicare or the disability. It's a, uh, hospital indemnity policy. Um, it provides like a certain indemnity amount uh for emergency room, urgent care, treatment in a physician's office, hospital confinement, um.
[CUSTOMER][NEUTRAL] But I don't, I mean, she's not on Medicare.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it does cover office visits.
[AGENT][NEUTRAL] It, it does not cover the fee for the office visit, but if she had treatment in the office visit, it would cover, it would pay a $50 benefit per day.
[AGENT][NEUTRAL] For the treatment that's done, not the.
[CUSTOMER][NEGATIVE] What do you mean a shit, uh, so, so it doesn't cover the office, is it?
[AGENT][NEUTRAL] Like if she
[AGENT][NEUTRAL] Right, the physician's fee. No, for the office visit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Only, only the treatment like so if she had, um, they, you know, we're checking her, yeah, blood pressure, it would be $50. Um, it's the maximum per day.
[CUSTOMER][NEUTRAL] Shots or something like that.
[CUSTOMER][NEUTRAL] Well, I mean, we do check blood pressure and all that. I mean, that's normal in the doctor's office.
[AGENT][NEUTRAL] Right. Well, it's just depending on the codeine. Right, and it's just depending on what the codeine is. If it's like a, a diagnostic testing or something that is just like a, a well visit, um, it would not cover that. Um.
[CUSTOMER][NEUTRAL] No, we don't do well visits. We do, um, we're cardiologists.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So if it is something to, she has a heart problem, has a diagnosis, and that would be considered treatment. Um,
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] But now we'll tell you that her coverage has not been lapsed or terminated. It's showing that it is active, but it's only showing that we have premiums through [PII]. So more than likely if she's on disability, she's not paying her premiums, so, um, or, you know.
[AGENT][NEUTRAL] We don't have current premiums right now, um, and it could be that the um employer has not mailed in the premiums yet, um, so I will let you know that.
[CUSTOMER][NEUTRAL] All right
[CUSTOMER][NEGATIVE] So she's not paid her current premiums.
[AGENT][NEUTRAL] Right, right, well, it's either she, the employer has not paid them.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEGATIVE] And if she's terminated, you know, she ends up being terminated, coverage would not be effective. So if she's on disability, you know, I don't know how they're taking out her premiums.
[CUSTOMER][NEUTRAL] Yeah, we, and she's already gone. I don't know um I don't even know where the disability is OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, you can always file the claim and we can review it, um, but I do have to tell you this call is not a guarantee and benefits, um, it's just giving you [PII]at benefits are.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] All right thank you.
[AGENT][POSITIVE] My pleasure. Is there anything else I can help you out with, [PII]?
[CUSTOMER][POSITIVE] No, that's it I appreciate it.
[AGENT][POSITIVE] Oh, my pleasure, [PII], you have a wonderful day and thank you for calling American Public Life.
[CUSTOMER][NEUTRAL] You too, bye bye.
[AGENT][POSITIVE] Thank you. Goodbye.