AccountId: 011433970860
ContactId: 6de2ffa5-1445-4b00-a74c-d614ece4cd16
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 263630 ms
Total Talk Time (AGENT): 102794 ms
Total Talk Time (CUSTOMER): 99883 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/6de2ffa5-1445-4b00-a74c-d614ece4cd16_20250204T15:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. My name is [PII]. I'm calling you from my provider's office. I have a patient here that has his primary insurance, Cigna, and Cigna is not covering because of deductible, and I was advised that this insurance will cover for that, will cover for the visit instead, so I need your information please.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, I can get you benefits and you said your name was [PII]?
[CUSTOMER][POSITIVE] [PII] correct.
[AGENT][POSITIVE] Thank you ma'am and then what is your callback number please?
[CUSTOMER][NEUTRAL] That is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, thank you. And what's the patient's name?
[CUSTOMER][NEUTRAL] Uh, it's for [PII]. Let me spell it for you. It's the first name is [PII]
[CUSTOMER][NEUTRAL] Last name is [PII]
[AGENT][NEUTRAL] OK, and then what is his date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the policy number, please?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I have a certificate number.
[AGENT][POSITIVE] Yes, that's good.
[CUSTOMER][NEUTRAL] Is that what you're looking for? OK, I have one that says hospital and one that says outpatient, so the outpatient is the one, right?
[AGENT][NEUTRAL] Either one is fine.
[CUSTOMER][NEUTRAL] Either one, OK, [PII] [PII] [PII].
[AGENT][NEUTRAL] OK, let me pull that up real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, I do show that um.
[AGENT][NEUTRAL] [PII] does have.
[AGENT][NEUTRAL] An active policy. His effective date is [PII], and you are correct, and this is just to verify his benefits. It's not a guarantee of payment. This is a supplemental insurance policy that is billed secondary to the primary. It does help with deductible, co-pay, and co-insurance.
[AGENT][NEUTRAL] He has an inpatient benefit amount per calendar year of $500 and then he has an outpatient per calendar day benefit of $500.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So in that in this case we filed first to to the primary and then.
[CUSTOMER][NEUTRAL] And then they file you or we file you as well?
[AGENT][NEUTRAL] Uh, you could file first to the primary and then when you file for us you'll need to send the explanation of benefits from the primary with the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have um.
[CUSTOMER][NEUTRAL] Do you have a payer ID for electronic claim submission?
[AGENT][NEUTRAL] Yes, ma'am. It is 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, 60 80 81.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So 6 digits.
[AGENT][NEUTRAL] Yes, ma'am, 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, is there any co-payment for the visit?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] Can you confirm what would be the claim submission address in case that we decide to do paper?
[AGENT][NEUTRAL] Yes ma'am, it's APL claims and that is [PII], that's in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty, OK, perfect, I appreciate it thank you very much for your help.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. You have a good week and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you you too as well.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][POSITIVE] Thanks bye bye.