AccountId: 011433970860
ContactId: 829ccc88-b3c7-49d6-a76b-596f55f84a68
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243080 ms
Total Talk Time (AGENT): 116765 ms
Total Talk Time (CUSTOMER): 91202 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/829ccc88-b3c7-49d6-a76b-596f55f84a68_20250203T20:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, hi, this is [PII] with Bates County Memorial Hospital, and I was calling regarding a patient, um.
[CUSTOMER][NEUTRAL] We just we just found out that he had um.
[CUSTOMER][NEUTRAL] The APL insurance um as a secondary and so I was calling to check and see um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] He's got some
[CUSTOMER][NEUTRAL] Like chemo and infusions orders that um he's been getting um and so we were calling to to see about his coverages with with you guys to see if that required an off or what.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Got you. OK, alright, we can check to see, um, we'll take a look at those benefits, make sure that that that kind of stuff would be covered, um, then of course to make sure that the policy is active, um, and I'm so sorry you did say your name was [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, and then before we go any further, can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. Do you have that policy number?
[CUSTOMER][NEUTRAL] I do it is.
[CUSTOMER][NEUTRAL] 01835977
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. And then what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] It is [PII] [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that, [PII]. Uh, so this policy is active. The effective date was [PII], and as this is a secondary medical policy, it is designed to help with copay, deductible and co-insurance after major medical pays. Uh, so this plan is very dependent on major medical. If they are not willing to pay, this plan can't, um, if they do, then this plan can.
[AGENT][NEUTRAL] So that being said, there is no authorization required for anything as long as their major medical is willing to do it.
[CUSTOMER][NEUTRAL] OK, so basically.
[AGENT][NEUTRAL] Does that make sense?
[CUSTOMER][NEUTRAL] Yeah, so you guys pay if his primary pays and you don't pay like as an assistant or whatever and then if you will not pay if his primary does not pay.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] OK, and that doesn't matter what he gets done that's for everything?
[AGENT][NEUTRAL] Yes, that is for everything. This plan is absolutely just secondary to whoever he has as his major medical.
[CUSTOMER][NEUTRAL] OK, so and then that.
[AGENT][NEUTRAL] And so it's not so much uh there's some confusion um that's why I don't like calling it a gap or anything because it cannot be used on its own.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So no no author required as long as primary.
[CUSTOMER][NEUTRAL] Agrees to pay.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, and um.
[CUSTOMER][NEUTRAL] Is there anything like you guys can send this in writing that that states that or?
[CUSTOMER][NEUTRAL] Is it strictly I don't know if there's anything online that we can look up or is it um.
[AGENT][NEUTRAL] Yeah, um, it would definitely be online, um, our website, uh, is [PII], so [PII]. um and this policy, it's called [PII], so [PII] is just the plan name, but it is our secondary medical policy.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And what was your name again?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] And your last initial?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] All right, and, and is there a reference number for this call?
[AGENT][NEUTRAL] It would just be my first name, last initial, and today's date. Oh, was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] I don't think so. I appreciate your help.
[AGENT][POSITIVE] Alright, of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] Bye bye.