AccountId: 011433970860
ContactId: 785cb9ee-9cbe-437f-a972-45300bcf714f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 392350 ms
Total Talk Time (AGENT): 198587 ms
Total Talk Time (CUSTOMER): 182201 ms
Interruptions: 4
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/785cb9ee-9cbe-437f-a972-45300bcf714f_20250311T15:06_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, um, good morning, um, my name is [PII], and, um, I have a question, um.
[CUSTOMER][NEUTRAL] I have the the um the American public life right from my work.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And um but this is good for um an insurance, you have to pay insurance for work.
[CUSTOMER][NEUTRAL] Can you just verify for me?
[AGENT][NEUTRAL] Um, what was your question? So sorry.
[CUSTOMER][NEUTRAL] OK, because I don't have my work insurance. I have another I have another insurance. Can I use the APL, um, to pay?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, so we just need to verify what kind of uh policy you have with us of, uh, medical, is that right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can get your policy pulled up and uh we'll take a look at what kind that is and how you can use that. um, can I first get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] OK, my number is [PII]. That's my cell phone, but I'm at work right now.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, got it. Thank you. Um, do you have your policy number?
[CUSTOMER][NEUTRAL] Um, OK, I have here the payers, the coverage individual, the group, um, the in-hospital benefits and outpatient benefits.
[AGENT][NEUTRAL] That will work either one that inpatient or outpatient, um, either one of those numbers please.
[CUSTOMER][NEUTRAL] OK, uh huh um 02592534.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 8.
[AGENT][NEUTRAL] OK, got it, thank you. And then, uh, [PII], just gonna verify some information really quick. Um, can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then can I get your mailing address?
[CUSTOMER][NEUTRAL] Oh, I don't even know which, uh, I think it's [PII].
[AGENT][NEUTRAL] Um, no, I've got a different one. It is in [PII].
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] Yeah, wait, wait I have oh my goodness.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, just a second, OK?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh [PII], is it that one?
[AGENT][NEUTRAL] No, um, it is different. No, it is different, um, it's.
[CUSTOMER][NEUTRAL] OK, no, OK, wait, because I have to [PII].
[AGENT][NEUTRAL] That's it, yes, that is what we've got, um, now does that need to be changed or is that correct?
[CUSTOMER][POSITIVE] No, that's correct. Oh.
[AGENT][NEUTRAL] OK awesome alright yes I just wanted to make sure um last thing I need [PII] is the email address we've got on file for you uh looks like it is a Gmail account.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. OK, thank you so much for verifying all of that information. OK, so this is a secondary medical policy. So it is designed to help with uh co-pay, deductible and co-insurance after your uh primary uh insurance pays.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] So it works hand in hand with whoever you have as your primary. Uh, it can't be used instead. So essentially if your primary is not willing to pay for a procedure or treatment, this policy can't either. It is designed to just help with that.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, like for example, like tomorrow I have to go for a mammogram and a breast ultrasound, right? And let me see how much they're charging me, um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] You let me see uh.
[CUSTOMER][NEGATIVE] Oh gosh, I forgot how much I have to pay like $200 something dollars.
[AGENT][NEUTRAL] OK, and that's after your primary, um, that pays correct?
[CUSTOMER][NEUTRAL] Yeah, uh huh, yeah, you have to pay $244.
[AGENT][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] Got you, of course, um, and then of course I will let you know verification of coverage is not a guarantee of payment for claims, um, so your outpatient benefit, which that's what that would fall under, um, it on a per calendar day basis, so it pays up to $500 per calendar day and again that goes towards co-pay, deductible or co-insurance.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so I will give this to to my tomorrow when I go to the hospital. I will give this to them.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Absolutely, uh, give them make sure they have both um your primary and this policy as well, um, and they should file those claims for you now some providers don't uh file claims for secondary or supplemental coverage if for some reason, uh, they're, you know, maybe they've not heard of this policy or anything like that they are more than welcome to give us a call and maybe we could try to alleviate some confusion.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] Um, but worst come to worst, uh, if they don't file the claim for you, you can still file the claim and we can tell you how to do that, but hopefully they'll just do it for you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Great, great, thank you and you said your name is?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh, my name is [PII], yeah, [PII]
[CUSTOMER][NEUTRAL] And your name is?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, perfect, yeah, because tomorrow, like tomorrow I have to go for the for the mammogram, the sonogram, and that's how much I have to pay, um, I just wanna confirm that.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Right, and that's what this policy is designed to help with, yes ma'am.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And this is also for medicine too as well? No? Not for medicine? Yes, sir.
[AGENT][NEUTRAL] Um, prescription, you mean prescription card?
[CUSTOMER][NEGATIVE] Yeah. Oh no.
[AGENT][NEUTRAL] Um, let me see if there's any prescription benefits. Give me just a moment. Um, all of these policies are pretty different, so I'm gonna get your policy pulled up and we can take a look at that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so, uh, prescription medication is not going to be covered under this policy.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] OK, OK, perfect, thank you, thank you very much.
[AGENT][POSITIVE] You are very welcome. Did you have any other questions for me?
[CUSTOMER][POSITIVE] No, no, that's what I needed thank you.
[AGENT][POSITIVE] OK, yeah, thanks for calling APL I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.