AccountId: 011433970860
ContactId: 55819e4e-da53-4bad-b135-3b0cc0424fa6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 323510 ms
Total Talk Time (AGENT): 176975 ms
Total Talk Time (CUSTOMER): 140919 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/55819e4e-da53-4bad-b135-3b0cc0424fa6_20250205T15:53_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. I was calling to see, I have a scheduled procedure for the, oh God, let me see, I forgot. I think it's the [PII] I believe.
[CUSTOMER][NEUTRAL] Sorry, I had it written down.
[CUSTOMER][NEUTRAL] Yes, it's on the [PII]. And I just wanted to see, um, I have to pay like a co-pay and then I have to pay like the facility and I just wanted to see what my coverage was.
[AGENT][POSITIVE] It would be my pleasure to assist you. Do you have your policy ID number available?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's that number.
[CUSTOMER][NEUTRAL] OK. 02503207.
[AGENT][NEUTRAL] Thank you and what is your name and date of birth please, ma'am?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And can you verify your current mailing address and a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII] and I know he had the 5515 green sign. I don't know if he's changed that to the PO box or not.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We have the home address, the street address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And for him to change that, does he have to call in because it's uh for my husband's insurance from work.
[AGENT][NEUTRAL] Yeah, it, he would have to call in to make that um change or he can email care [PII] and we can do it via email.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I will let him know, but yeah, OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right, so I'm showing that the policy is active, of course, at [PII]. Is, will this be in an outpatient facility?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sorry, I was taking a drink of water. Yes, it is. It is going, I'm sorry. I, I needed a drink.
[AGENT][NEUTRAL] You're fine.
[AGENT][NEUTRAL] I understand.
[CUSTOMER][NEUTRAL] And uh, oh, let me go back to my, I have everything on my text messages because if not I will forget. Um, it's yes, but if not, I'm like, and I write everything down, but I'm like, oh my God, I forget again, I'm trying to look for it now. And it always happens when you're not ready, it's when it's um.
[AGENT][NEUTRAL] Yeah I know who.
[AGENT][POSITIVE] Oh, you take your time.
[AGENT][NEUTRAL] I am here for you. We'll just.
[CUSTOMER][NEUTRAL] Um,
[AGENT][POSITIVE] It's not a problem.
[CUSTOMER][NEUTRAL] It's uh, it's just uh, I've had it, I think I've, it's on [PII], I think it was [PII].
[AGENT][NEUTRAL] And that is
[AGENT][NEUTRAL] And that will be an outpatient facility.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, so we do have you do have coverage for outpatient services up to $1500 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now that is a verification of coverage on your benefits on your policy. It's not a guarantee of payment, simply means we can't guarantee payment until we have the claim in the house.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, so they need to call and make the claim, or how does that work or?
[AGENT][NEUTRAL] So make sure that you give them your APL policy ID card.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Now, they should file a claim for you so that you don't have to pay.
[AGENT][NEUTRAL] Out of pocket
[AGENT][NEUTRAL] Prior to the services performed.
[AGENT][NEUTRAL] They'll normally, once they'll file it with your primary insurance, and once they get that back from your primary, then they will file with APL and we can, if it is a covered procedure, then we can provide that up to $1500 for that procedure depending on how your primary insurance processes. If they only apply, say, $500 to your deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Well then we would only apply $500 pay $500. So it all depends on what they apply to your deductible, co-pay, or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I found it it's GA GAB endoscopy. I don't know if I'm pronouncing it right. Sinner.
[AGENT][NEUTRAL] In the endoscopy, yeah, I got you. Endoscopy center.
[CUSTOMER][NEUTRAL] Yes, I just say it's slow cause I don't know if I'm, I'm saying it right or not.
[AGENT][NEUTRAL] One of those indos.
[AGENT][NEGATIVE] That's a hard word. I have trouble with that. I get tripped up on that one too.
[CUSTOMER][NEUTRAL] It is.
[AGENT][POSITIVE] For sure, yeah.
[CUSTOMER][NEUTRAL] Yeah, it was the email, yeah, I found it.
[AGENT][NEUTRAL] OK, yeah, so that should be considered an outpatient facility. Of course, I can't guarantee it until we receive the claim on file, but it shouldn't be any problems, and they should file the claim for you. Um, they can call us, we'll be happy to verify your benefits on your policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Just whatever we need to do to help you.
[CUSTOMER][POSITIVE] OK, I just wanted to make sure that I'm gonna call them back right now and let them know because they left me a voicemail yesterday. I said no, let me call the entrance first and make sure, but OK, I think I'm gonna do that. Thank you so much.
[AGENT][POSITIVE] It's been such a pleasure to assist you, Ms. [PII]. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] That will be it, thank you.
[AGENT][POSITIVE] Oh, thank you for calling APL. I hope you have a wonderful day. I hope everything goes well with your procedure, but you call us if you have any questions or concerns.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you, Ms. [PII]. Take care.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Bye bye.