AccountId: 011433970860
ContactId: 46374650-53c5-449e-a79e-cc24470a7830
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 282019 ms
Total Talk Time (AGENT): 129061 ms
Total Talk Time (CUSTOMER): 117048 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/46374650-53c5-449e-a79e-cc24470a7830_20250122T17:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, um, I'm calling because I wanted to see something about the gap insurance.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Uh, my name is [PII] and uh fax number is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. And now, could I get the policy number that you're calling about?
[CUSTOMER][NEUTRAL] 8022.
[CUSTOMER][NEUTRAL] 865.
[CUSTOMER][NEUTRAL] 09 ML 8.
[AGENT][NEUTRAL] And please verify your first and last name and your date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you. And please verify your email address and your home address to make sure we have the correct ones on file.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your email address, please?
[CUSTOMER][NEUTRAL] It'll be my first name [PII].
[AGENT][POSITIVE] OK. Yes, ma'am. And how can I help you?
[CUSTOMER][NEUTRAL] OK. I recently had a, not a procedure, but like an ultrasound for NT.
[CUSTOMER][NEUTRAL] Um, and the office had gathered my gap insurance and my regular insurance. I just wanted to see if they've made a claim.
[AGENT][NEUTRAL] OK, yeah, I'm showing um this is coverage for your gap insurance.
[CUSTOMER][POSITIVE] Thank you
[AGENT][NEUTRAL] And yes, for outpatient benefits, we cover up to 500 per day. That's after the copay, the co-insurance, and the deductible processes the claim. Um, let's see. And I'm showing the effective date on your policy was [PII] and your policy is still active.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And is there any particular benefit that you would like to verify?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, I don't know if you can see if that doctor, the doctor's appointment has put in the claim for the NT sonogram.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Because I had, I had to pay a deductible and they're like, oh, if your gap insurance pays, then we'll go ahead and, and um reverse the money.
[AGENT][NEUTRAL] OK. Well, no, ma'am. The most, um, the last claim that I show on file for you, it was filed back in [PII], so they haven't submitted the claim with us yet.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] They haven't submitted his claims. OK. And a quick question now with the, with the OBGYN, the doctor's office, um, I have to pay for the pre-delivery and post office and they told me they don't accept gap insurance, so I would have to submit the claim to to you guys. How can I do that?
[AGENT][NEUTRAL] OK. You can file the claim online. Um, you can mail us the information. Yeah, you can mail us the information or you can fax it in. Which way do you prefer?
[CUSTOMER][NEUTRAL] Online.
[CUSTOMER][NEUTRAL] I can do it online and can I do it also for this claim of the NT sonogram?
[AGENT][NEUTRAL] Um, yes, ma'am. If you get what we'll need is the EOB from your primary insurance company for the date of service, and we will need your diagnosis code. And that's very important cause a lot of people forget to write their diagnosis code on the EOB. The diagnosis code is the code for the illness.
[AGENT][NEUTRAL] Or the reason why you're seeing the doctor. Once you gather the EOB from your primary insurance, get that information from your doctor and write it on there along with your policy number. And yes, you can file the um claim online or again, fax it to us or send it through the mail.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect and that will be for both um the NT sonogram and the free delivery and post.
[CUSTOMER][NEUTRAL] Of the um
[CUSTOMER][NEUTRAL] Uh, for both names it has to have the EOB and uh.
[CUSTOMER][NEUTRAL] Everything, right?
[AGENT][NEUTRAL] The the the EOB and your diagnosis code. Yes, ma'am.
[CUSTOMER][NEUTRAL] Diagnosis.
[CUSTOMER][NEUTRAL] EOB and diagnosis called.
[AGENT][NEUTRAL] Yes, ma'am. The EOB from your primary insurance company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect alrighty thank you so much.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] No, that'll be all.
[AGENT][POSITIVE] OK. Well, I thank you again, [PII] for calling APL. You have a great rest of your day. Bye.
[CUSTOMER][NEUTRAL] Likewise bye bye.
[AGENT][POSITIVE] Mm thank you