AccountId: 011433970860
ContactId: 9ed275f4-f709-4cdf-b3bb-48a9f6a3a6c6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 238889 ms
Total Talk Time (AGENT): 122483 ms
Total Talk Time (CUSTOMER): 82113 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/9ed275f4-f709-4cdf-b3bb-48a9f6a3a6c6_20250107T22:10_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], I was just calling to see, I wasn't, um, I'm calling from a provider's office and I wasn't, I wanted to see what kind of coverage this plan had for chiropractic care.
[AGENT][POSITIVE] OK, I'm happy to take a look. Do you have the uh patient's policy?
[CUSTOMER][NEUTRAL] Yes ma'am, it is um 02479853.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right. Thank you so much. Let me pull this up here, one moment.
[AGENT][NEUTRAL] And if you don't mind, can I grab your first name?
[CUSTOMER][NEUTRAL] Sure, it's [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And then what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] OK, her name is [PII] and her birthday is [PII].
[AGENT][NEUTRAL] All right, thank you so much. So this is a secondary plan. So this is going to, uh, it is active. The effective date is [PII] if you need that. Uh, this is gonna cover deductible co-pay, co-insurance that the primary does not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me just see if it will cover, sometimes it will cover treatment but not the office visit fee, so I just need to check on that.
[CUSTOMER][POSITIVE] Wow
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] So it looks like the outpatient benefit max is gonna be $500 and that's per occurrence which would mean being seen for the same thing.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] And so it looks like this will cover any sort of treatment in a physician's office. It does also cover any sort of co-pay, um, physician office visit fee as well.
[CUSTOMER][NEUTRAL] Oh, so would that that would include like the exam fee.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh great OK, so same thing I just file it to their primary first and then send um another insurance claim with the EOB to you guys.
[AGENT][POSITIVE] Absolutely, yes, ma'am.
[CUSTOMER][POSITIVE] All right great all right thank you.
[AGENT][POSITIVE] You're welcome, [PII]. Anything else I can do for you?
[CUSTOMER][NEUTRAL] No ma'am that's all.
[AGENT][POSITIVE] All right. Have a good day.
[CUSTOMER][NEUTRAL] Well, actually I will actually I wanna ask you a question. How I haven't, so this is kind of like this is personal now this is like a gap insurance I guess it would be called or or a secondary is do you guys do you cover any kind like just are you the pri secondary for any primary even if it's not a an ACA insurance or does it have to be an ACA plan?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm, yeah, so no, I mean, um, we offer secondary to through, yeah, a lot of different plans. So yeah, a lot of people can have us as like a, a lot of people will call it like a gap or uh secondary, yeah.
[CUSTOMER][NEUTRAL] OK, so what's what would be a good number to call an agent and talk to about this?
[AGENT][NEUTRAL] Um, so I don't know, let's see if we sell individual, I'm a newer agent. Give me just a second. I think it may only be through you're talking about just pur purchasing a policy separately on your own, correct?
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] Yeah, so they only do it through um groups at this time. It's not something, yeah, unfortunately you can just purchase on its own.
[CUSTOMER][NEUTRAL] Oh, got you.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] OK, well thank you anyway.
[AGENT][POSITIVE] You're welcome, [PII]. Have a nice day.
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] You too bye bye.