AccountId: 011433970860
ContactId: afd3116b-26d2-4cb3-9aa9-48ab6491a035
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 239339 ms
Total Talk Time (AGENT): 154784 ms
Total Talk Time (CUSTOMER): 55232 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/afd3116b-26d2-4cb3-9aa9-48ab6491a035_20250604T14:57_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Yes, hi, good morning. I'm calling to verify the member's active with the insurance.
[AGENT][POSITIVE] OK, I'd be glad to help you. Go ahead and give me your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] It's gonna be 02158743 ML 7.
[AGENT][NEUTRAL] Alrighty, [PII], thank you for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, [PII], thank you for all that information. Now, your patient's name and date of birth today, please, ma'am.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Alrighty, thank you for all that, [PII]. It looks like yourself is a dependent on this medical supplemental plan, but I do show this number is terminated, so let me go and see if they flip to a different number right quick. So bear with me. Let's see.
[CUSTOMER][POSITIVE] Oh thank you.
[AGENT][NEUTRAL] Yeah, it looks like they probably did. So hang on, let me get it pulled up.
[AGENT][NEUTRAL] To
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Yeah looks like they put a different number. Let me get it pulled up. Let's see.
[AGENT][NEUTRAL] Yeah, I flipped um number so let me, [PII] first I'll give you the correct policy number that needs to be filed on your claim when you send it into APL that's gonna be policy number yes ma'am, 02.
[CUSTOMER][NEUTRAL] OK, go ahead please.
[AGENT][NEUTRAL] 59.
[AGENT][NEUTRAL] 5840.
[CUSTOMER][NEUTRAL] OK, no letters?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All righty.
[CUSTOMER][NEUTRAL] And this is for inpatient hospital, correct?
[AGENT][NEUTRAL] OK, inpatient hospital. Oh, and you did say you want benefits, is that correct?
[CUSTOMER][POSITIVE] Yes please.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alrighty, let me get their benefit pulled up. Now, of course, what we are seeing is just their medical supplemental plan. So the only thing we will pick up and pay on is anything that is applied towards patients deductible, co-pay, or coinsurance at their primary insurance carrier for sickness and injury only. Nothing routine here is covered no matter what. I do show this effective date on this medical supplemental plan being [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII] patient is current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but you do want inpatient benefits, correct?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] Alright, the inpatient benefit here at APL is a $0 deductible, no pre-cert, and they have a $5000 benefit payable per calendar year.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, and then if I guess it follows what?
[CUSTOMER][NEUTRAL] Oh, OK. Medicare guidelines, I guess I don't know.
[AGENT][NEUTRAL] No, ma'am, we do not coordinate with Medicare. This is a medical supplemental plan.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Got you medical.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Supplement
[CUSTOMER][POSITIVE] Plan. OK, perfect. Can you spell your first name please?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] I sure can. [PII], is that all I can help answer for you today?
[CUSTOMER][POSITIVE] Yes please thank you.
[AGENT][NEUTRAL] Alrighty, yes, ma'am. Um, and we don't give reference numbers [PII], but you can use my name in today's date if you need to do so, and my name is spelled [PII]
[CUSTOMER][NEUTRAL] Your last name initial?
[AGENT][NEUTRAL] Is it [PII]?
[CUSTOMER][NEUTRAL] Oh, and then today's date, OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK sounds good thank you for your time.
[AGENT][POSITIVE] Alright [PII]. Yes, ma'am, and thanks for calling APL Sydney. Have a great day.
[CUSTOMER][NEUTRAL] Same to you bye bye.
[AGENT][POSITIVE] Thank you mate. Bye bye.