AccountId: 011433970860
ContactId: 9499c174-4261-45a1-8d3b-32f23299d727
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 255979 ms
Total Talk Time (AGENT): 124081 ms
Total Talk Time (CUSTOMER): 118185 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/9499c174-4261-45a1-8d3b-32f23299d727_20250130T20:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from a facility and uh a patient told me that he has American Life uh gap insurance, American Public Life gap insurance, and I just wanted to see if I can verify benefits.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure, yeah, we can look at benefits. Uh, what was your name?
[CUSTOMER][NEUTRAL] My name's [PII].
[CUSTOMER][NEUTRAL] Hi this is calling.
[AGENT][NEUTRAL] What was it? I'm sorry.
[CUSTOMER][NEUTRAL] Uh, [PII]
[AGENT][NEUTRAL] Just on, OK, and can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Sure, my number is [PII] and that's my direct line.
[AGENT][NEUTRAL] All right, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Um, so I have a number he gave me, but I'm not sure if it's the policy.
[AGENT][NEUTRAL] OK, we can give it a shot.
[CUSTOMER][NEUTRAL] Uh, the number
[CUSTOMER][NEUTRAL] The number he gave me was 024351.
[CUSTOMER][NEUTRAL] 72 M.
[CUSTOMER][NEUTRAL] 18.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Or hold on.
[AGENT][NEUTRAL] One moment. That's OK. Um, that is the policy number, yeah, that's fine. Um, the number before the M is really the most important part, um, OK, uh, what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] MLA
[CUSTOMER][NEUTRAL] It's an L.
[CUSTOMER][NEUTRAL] MLA sorry uh you wanted what?
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Uh, the name and date of birth for the insured, please.
[CUSTOMER][NEUTRAL] So the name is [PII].
[CUSTOMER][NEUTRAL] Uh, last name [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Date of birth of [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we really need to look at the uh outpatient benefits.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. Uh, so their outpatient benefit is on a per calendar day basis, so it is $500 max per calendar day.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I have another question, um, so he's also coming in for a um a cardiac scoring which isn't normally covered by.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um, insurances, is this something that you guys would cover?
[AGENT][NEUTRAL] Um, well, is his major medical or his primary, are they going to be paying?
[CUSTOMER][NEUTRAL] Uh, this is something that's not typically covered by insurances.
[AGENT][NEUTRAL] OK, so this plan is very dependent on the major medical if they are not willing to pay then this policy cannot. If they do then this policy can.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] OK, he's coming in for a couple of things. I just, I see on the note that it says for the scoring, OK.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yeah, it's, it's this plan is very dependent on the primary coverage.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] And uh just to clarify one thing, the number between M and then the 8 is that was it supposed to be an L or an I?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] It's, it's typically an L, um, honestly, the number before the M is all we really need, um, the ML8 or ML7 that's usually just to differentiate between inpatient or outpatient, but really that the policy number is what's before the M.
[CUSTOMER][NEUTRAL] Ah.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah, did you have any other questions for me?
[CUSTOMER][NEUTRAL] Uh, no, is there a way I, I can get like a call reference number for this call or?
[AGENT][NEUTRAL] Of course, yeah, definitely that would be my first name, last initial, and today's date. Uh, so my name is spelled [PII], last [PII]
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] All right, thank you so much for your help.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you bye.
[AGENT][POSITIVE] Thank you. Bye bye.