AccountId: 011433970860
ContactId: aac7efcb-0a27-45fc-9f2f-30a06110265b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 220600 ms
Total Talk Time (AGENT): 93831 ms
Total Talk Time (CUSTOMER): 110804 ms
Interruptions: 5
Overall Sentiment: AGENT=2.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/aac7efcb-0a27-45fc-9f2f-30a06110265b_20250321T12:31_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting APO. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey this is [PII]. I have a provider's office on the line and they need to check um.
[CUSTOMER][NEUTRAL] Benefits for an insured. I'm so sorry I went blank. They need to check the benefits. She was asking like the deductible what we would pay that kind of thing on a midlink policy, um, but the policy number is 231-731-0.
[AGENT][NEUTRAL] Sure, of course.
[AGENT][POSITIVE] Thank you. And who is on the phone?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Her name is [PII]. She spelled it [PII], [PII].
[AGENT][POSITIVE] Great. I, I can certainly help her.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, I do have her callback number [PII].
[AGENT][POSITIVE] OK, thank you. I, I, I can take it from here. Thanks.
[CUSTOMER][NEUTRAL] OK. And, and did verify the birthday of the insured, but that was all. Um, so, OK.
[AGENT][POSITIVE] Yeah, thank you. That's great.
[CUSTOMER][POSITIVE] All right, here she comes. Thank you.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] You didn't put it in the system, did you? No, I don't even know how to put it in. I didn't either.
[AGENT][NEUTRAL] OK. Thank you for contacting APL. My name is [PII]. I'm in the claims department. I understand that you wanted to know about the benefits for [PII], uh, yes. So, first of all, this policy went into effect on [PII]. It is active. Now, this is a secondary or gap insurance and what we do is we pick, we pick up the deductible, co-payment or co-insurance from his major medical for inpatient, outpatient services.
[CUSTOMER][NEUTRAL] Huh
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Gap Insurance mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, mhm.
[AGENT][NEUTRAL] Treatment within a physician's office. Is there anything in particular that I could tell you about the secondary or gap insurance?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so the the patient has a primary, um, insurance, so it will pick up the copay.
[AGENT][NEUTRAL] Well, it won't, it's, uh, the co-pay for the office visit, um, it's not going to, it's not going to pick that up. And so what it will do is it will pick up the treatment uh within the physician's office but not the office visit co-pay.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] Oh, but this is a surgical center, so it will pick up the copay.
[AGENT][NEUTRAL] Uh, yes, yes, it will. We will pick up the deductible, co-payment or co-insurance up to $500 per calendar day. That's just a verification. Yes, ma'am. Uh, that's just a verification, not a guarantee of payment. Um, is there anything else at all that I can tell you about the
[CUSTOMER][POSITIVE] Oh OK perfect.
[CUSTOMER][POSITIVE] $500. OK, perfect.
[CUSTOMER][NEUTRAL] Give yes, give me 11 moment please, one moment.
[AGENT][NEUTRAL] Certainly.
[CUSTOMER][NEUTRAL] OK, um, so I will pick up the, um, copay deductible, and they have available up to $500 nothing has been used from the high $500.
[AGENT][NEUTRAL] No, it's, it's right, yes, it's per calendar day. Yes, it is available.
[CUSTOMER][NEUTRAL] Is available?
[CUSTOMER][POSITIVE] OK, perfect. Can I get a reference number please?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name [PII], and we're gonna use that today's date as a reference. Any anything else at all I can tell you? Anything else at all I can help with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] is your name? It's [PII] and initial last name?
[AGENT][POSITIVE] Yes, ma'am, that's right.
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][POSITIVE] OK perfect thank you [PII] so much OK bye bye.
[AGENT][POSITIVE] Mhm thanks for contacting AP have a good.