AccountId: 011433970860
ContactId: 5a0d7317-3c9e-4f3e-b5d8-f30491027668
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180229 ms
Total Talk Time (AGENT): 47694 ms
Total Talk Time (CUSTOMER): 96715 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/5a0d7317-3c9e-4f3e-b5d8-f30491027668_20250512T15:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling from McLaren Flint, and I have a question regarding the payment on this claim.
[AGENT][NEUTRAL] OK, [PII], I can help you with claim status. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And you have the policy number for that patient?
[CUSTOMER][NEUTRAL] Yep, it is um.
[CUSTOMER][NEUTRAL] 02491003
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] And this is for [PII] [PII].
[AGENT][NEUTRAL] And do you have that claim number?
[CUSTOMER][NEUTRAL] Yeah, it is 359238-8.
[AGENT][POSITIVE] OK, and how can I help you today?
[CUSTOMER][NEUTRAL] So there's only a flat $150 payment that the policy pays.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Just trying to figure out if there is a patient responsibility on this, um, because my concern is that the Medicare, um, you know, normally if this is an out of network policy, um.
[CUSTOMER][NEUTRAL] We get paid them at least the Medicare allowable.
[AGENT][NEUTRAL] Um, so,
[CUSTOMER][NEUTRAL] And that is.
[CUSTOMER][NEUTRAL] 685.
[AGENT][NEUTRAL] So this is a supplemental policy. It's a supplemental hospital indemnity policy. So because it's supplemental, it just
[CUSTOMER][NEUTRAL] 00, so they should have a primary?
[AGENT][NEUTRAL] Um, I don't know. I don't, let me see if I have anything on file.
[CUSTOMER][NEUTRAL] I know at one point they had Blue Cross.
[CUSTOMER][NEUTRAL] But I'm not sure if they have that now.
[AGENT][NEUTRAL] Um, I don't, I don't show any, any primary on file, um, but it's, it's like a supplemental policy cause it's offered through a, it's a temporary agency, so.
[AGENT][NEGATIVE] They don't offer benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh, OK. All right. So it just helps assist with that, yeah.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] All right. So,
[CUSTOMER][NEUTRAL] Um, all right, then I think I will.
[CUSTOMER][NEUTRAL] Bill the patient and then see if they provide any other information.
[CUSTOMER][NEUTRAL] You know, maybe there's another insurance and if not, this is just a supplemental, OK.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] All right, that helps.
[AGENT][NEUTRAL] OK. Anything else I can help you with?
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Nope, that's it. Thanks.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day. Bye bye.
[CUSTOMER][NEUTRAL] Yeah, bye now.