AccountId: 011433970860
ContactId: 5cc7cd36-d013-4a0d-8d03-561e934608d5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275859 ms
Total Talk Time (AGENT): 108855 ms
Total Talk Time (CUSTOMER): 140563 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/5cc7cd36-d013-4a0d-8d03-561e934608d5_20250328T18:54_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]. My name is [PII] and I'm calling from Arizona Digestive Institute.
[CUSTOMER][NEUTRAL] Um, I have a patient who is covered under a different insurance primary, but they have the American Public Life listed as a secondary insurance, so I needed to verify that this is indeed an active plan and just get a little bit of information about what kind of plan it is.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and what did you say your name was? I'm sorry?
[AGENT][NEUTRAL] That's OK. My name is [PII]. That's [PII]
[CUSTOMER][NEUTRAL] So, what's the first initial of your last name if you don't mind, please?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] Thank you, [PII] I appreciate your help today.
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] No problem. What is the patient's policy number, [PII]?
[CUSTOMER][NEUTRAL] Um, it is 949-198.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then do you have a good call back number [PII] just in case we're disconnected?
[CUSTOMER][NEUTRAL] Oh, absolutely. It's area code [PII] and my direct extension is [PII].
[AGENT][POSITIVE] Thank you so much. What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is for patient. Oh my gosh, I have so many patients here. [PII].
[CUSTOMER][NEUTRAL] And Mr. [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you for that. So the patient's plan is active. Uh, the effective date is going to be [PII].
[AGENT][NEUTRAL] We are the members secondary insurance, so it does cover deductible, co-pay, co-insurance that the primary does not.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like the outpatient benefit max on this plan for the calendar year is going to be $2000. That is of course verification of benefits, not guarantee of payment.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, um, and, and you just basically follow the guidelines of the primary, so you would cover for, OK, you would cover um for that and then finally, would you guys require a pre-authorization or would you just again go by the primary insurance?
[AGENT][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] Yeah, no pre-op is required. We'll just follow the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, that down.
[CUSTOMER][NEUTRAL] No Prius.
[CUSTOMER][NEUTRAL] OK perfect and then [PII], what do I use for a reference for our call today?
[AGENT][NEUTRAL] Absolutely. Call reference is my name with my last initial and then just put today's date which is going to be [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, and then one final question I do have to document time when I don't get a reference number. Could you tell me what time it is where you're at?
[AGENT][NEUTRAL] Absolutely. I'm on Central time. It's currently [PII]
[CUSTOMER][NEUTRAL] [PII] and then um the card says that claims get sent to [PII].
[AGENT][NEUTRAL] No, that's actually not correct. Let me give you the correct address.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, give me one second, HO.
[CUSTOMER][NEUTRAL] [PII]. OK, go ahead.
[AGENT][NEUTRAL] And zip code is [PII].
[CUSTOMER][NEUTRAL] And do you have an EDI or a payer ID number for electronic claims submissions?
[AGENT][NEUTRAL] Absolutely. It's 60801.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so it was [PII] with a payer ID of 60801.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, ma'am, that is correct.
[CUSTOMER][POSITIVE] OK, perfect. That's what I needed to know. Thank you so much for your help today. I really appreciate it, sir. Have a great day.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] You're welcome. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Uh huh bye bye.