AccountId: 011433970860
ContactId: 52fc6cf1-93bb-4500-b3e6-0c3bf1b47c3a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 370839 ms
Total Talk Time (AGENT): 136548 ms
Total Talk Time (CUSTOMER): 125107 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/52fc6cf1-93bb-4500-b3e6-0c3bf1b47c3a_20250516T15:10_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, I'm calling from AdventHealth Medical Group Family Medicine at [PII] on a recorded line. My name is [PII]. I just wanted to call and verify whether the um, the American Public Life, um, insurance is in network with AdventHealth.
[AGENT][NEUTRAL] OK, so you're trying to verify about this network in network or not, is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][POSITIVE] Yes, ma'am, I can help you and if you could spell your name for me please.
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], thank you. And your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] Uh, let's see here the.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Give me one moment please. I I'm looking at it but I'm not sure if I'm reading it correctly. OK, so it says subscriber ID is 02424891.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] M as in midnight, I as in igloo, L as in Lima.
[CUSTOMER][NEUTRAL] 7.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] And any information that I provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The patient's name is [PII]
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so this is, she's a subscriber on the supplemental policy and because it is a supplement to your primary insurance, there is no network with the policy with APL.
[CUSTOMER][NEUTRAL] OK, um,
[AGENT][NEUTRAL] Now, if you will, uh-huh, go ahead. It would follow her primary insurance.
[CUSTOMER][NEUTRAL] OK, yes, they do have their primary insurance. um, we, we know that we have set the primary insurance. I just wasn't sure if we were in network with this insurance. Are you saying that if the primary is in network then.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] There is no network. I'm saying there is no network with this supplemental policy.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK, uh, give me one moment please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hi, so I just, um, I'm a little bit confused. What does it mean for um that you don't have a network?
[AGENT][NEUTRAL] Because it's not a network plan. We're not a major medical carrier.
[AGENT][NEUTRAL] So there is no network affiliated with this type of policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and you're saying that it's because it's a supplemental?
[CUSTOMER][NEUTRAL] Uh, insurance?
[AGENT][NEUTRAL] This is a supplemental plan, yes, to her primary insurance that helps with co-pays, deductibles, and co-insurance amounts of coverage services.
[AGENT][NEUTRAL] But there is no network affiliated with this policy.
[AGENT][NEUTRAL] With APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, give me one moment please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hi. Um, are you able to see if, um, AdventHealth takes the, um, the insurance, the supplementary insurance?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] No, ma'am. I would not be able to check that for you.
[CUSTOMER][NEUTRAL] OK, no worries then. um, can you just verify whether this um supplementary insurance is active?
[AGENT][NEUTRAL] Yes, ma'am. It is active effects of [PII].
[CUSTOMER][NEUTRAL] Alright perfect um could I get the reference number for this call? Oh sorry.
[AGENT][NEUTRAL] And if you want
[AGENT][NEUTRAL] Yes, ma'am, it will be my name that I gave you along with today's date and just a couple of additional pieces of information, [PII].
[AGENT][NEUTRAL] If you will file a claim with us for this member, you must also send us a copy of the primary insurance company's explanation of benefits as well for review and then once we have processed our claim here at APO we do have a portal in which you should be able to check our claim status in and the website for that is located at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um, thank you. um can I get your name just one more time?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And that's [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] All right. Um, then that's all I have for now. Thank you so much for your help.
[AGENT][POSITIVE] OK, well, you're very welcome. So if that is all I can help you with you and thank you again for calling APL and I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You too bye now.
[AGENT][POSITIVE] Thank you. Bye bye.