AccountId: 011433970860
ContactId: abed5f7a-068f-4f3b-9182-4c99e727a4d8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 428829 ms
Total Talk Time (AGENT): 170624 ms
Total Talk Time (CUSTOMER): 152927 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/abed5f7a-068f-4f3b-9182-4c99e727a4d8_20250506T20:22_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider of Nationwide Medical.
[AGENT][POSITIVE] Hi [PII], how can I help you today?
[CUSTOMER][NEUTRAL] Uh, today, I have one member and uh could you confirm that, uh, the APL is the secondary insurance for the member or not?
[AGENT][NEUTRAL] I can. Would you give me that policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 02549418 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] All right, [PII], thank you for that. And while I'm pulling this up, go ahead and give me a good return telephone call number, just in case we get disconnected, please, ma'am.
[CUSTOMER][NEUTRAL] Uh, you are, my name is [PII]. The callback number is [PII].
[AGENT][NEUTRAL] All [PII], thank you for that, [PII]. Now, what's your patient's name and date of birth today?
[CUSTOMER][NEUTRAL] Member name and the date of birth.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And that date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Hello, [PII].
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes. Yes.
[AGENT][NEUTRAL] Hello, I can hear you now. OK, uh, looks like [PII] is it dependent on this medical supplemental plan. So you're checking to see if we are the supplemental plan, is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. So you, you are the supplemental plan.
[AGENT][NEUTRAL] Yes, ma'am, we are.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK. Like it is a HMO or PPO. OK, this is a supplemental plan.
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] Mhm. Yes, it is.
[CUSTOMER][NEUTRAL] OK. What is
[CUSTOMER][NEUTRAL] What is the effective date of this plan?
[AGENT][NEUTRAL] The effective date of this supplemental plan is [PII] current policy is active, but I must advise that verification of benefits is not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK. And uh could you check uh the we are contacted or not with the member plan?
[AGENT][NEUTRAL] I'm sorry, what was your question?
[CUSTOMER][NEUTRAL] Uh, I want to know about the VR, uh, in, in-network or out of network.
[AGENT][NEGATIVE] They're not a network with our company at all.
[CUSTOMER][NEUTRAL] OK, so we are off to network.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Well, we're not in a network, we're just a supplemental plan we only coordinate with that primary insurance company.
[CUSTOMER][NEUTRAL] OK. So, for this member, primary is uh the Aetna. Uh, so, could you tell me, do you, uh, pick up the primary deductible?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Depending on what patient is having done.
[CUSTOMER][NEUTRAL] Leftover primary.
[AGENT][NEUTRAL] Do you have an exact benefit?
[CUSTOMER][NEUTRAL] Uh, like for the DME services.
[AGENT][NEUTRAL] Oh, DME. OK, let me check that benefit right quick to see if they have that, [PII]. Hang on just a second. Let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Alright, looks like under this plan, [PII], they do not have any type of DME benefits here at all with APL. It's not gonna be covered.
[CUSTOMER][NEUTRAL] OK. So, under the supplemental plan, DMV services are not covered and you guys are not pay. Correct?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Correct. Yes, ma'am, no benefit payable.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hello, are you there?
[CUSTOMER][NEUTRAL] Yes. Yes, I'm checking something. Just
[AGENT][NEUTRAL] Hello? OK. Are there any?
[AGENT][NEUTRAL] OK. Is there anything else I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh no, just wait a moment. I'm checking something, OK? Just wait a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you so much for today's help. Now, could you provide me the claim mailing address?
[AGENT][NEUTRAL] Yes, our mailing address is to american Public Life.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We're in [PII].
[AGENT][NEUTRAL] Zip [PII].
[CUSTOMER][NEUTRAL] He
[CUSTOMER][NEUTRAL] [PII]. And what is the PIN uh ZIP code?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, got it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much. And now, could you spell your name and provide me the reference number for this call?
[AGENT][NEUTRAL] Well, we don't give reference number, [PII], but you can use my name and today's date and my name is spelled [PII] yes.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Uh, sorry, could you repeat it once?
[AGENT][NEUTRAL] Yes, ma'am. [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. Eli, uh, initial of your last name?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Thank you so much. And uh reference number you the name and today's date.
[AGENT][POSITIVE] That is correct, [PII].
[CUSTOMER][POSITIVE] Thank you so much for today, sir. Have a great day. Bye for now.
[AGENT][POSITIVE] You as well, [PII] and thanks for calling APL. Bye-bye.