AccountId: 011433970860
ContactId: b09c8c4b-1e52-428f-b0e1-8f86048fdb70
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 286279 ms
Total Talk Time (AGENT): 100014 ms
Total Talk Time (CUSTOMER): 109379 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/b09c8c4b-1e52-428f-b0e1-8f86048fdb70_20250320T12:57_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling from AdventHealth calling in reference to a patient on their benefits. Uh, the patient is using this plan as their secondary plan. We're just trying to get some information on the plan.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the member's policy and coverage. And just for my notes, can you spell your first name for me please and provide a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, my first name is [PII]
[CUSTOMER][NEUTRAL] Call back call back is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII], and may I have the member's policy number?
[CUSTOMER][NEUTRAL] Uh, I have here 02595368.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII]. Date of birth is what is her date of birth? [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment, and I am showing that the policy is active. It's been effective since [PII]. So this is our secondary policy we pay towards the copay, deductible and co-insurance of covered charges after primary. Um, it's broken down into inpatient and outpatient benefits, which are you all consider outpatient or this is the office?
[CUSTOMER][NEUTRAL] Uh, we, we'll consider outpatient hospital facility. She's having a surgery here. We just, and another question is like what is the network for this like.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So there's no network for secondary. Her primary may have a network, but we are second only to her primary, um, and the benefit is up to $750 per calendar day that she can use towards outpatient expenses.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, so, yeah, because we just, uh, we, we, we didn't even know she had a secondary insurance. We billed her at 2,700 $2760 and you guys will only cover up to $700 of that.
[AGENT][NEUTRAL] Yes, yes, the max per day for her is $750. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, one second here, let me grab a pen. 1 2nd.
[AGENT][NEUTRAL] OK. Sure.
[CUSTOMER][POSITIVE] I'm sorry about that. I work from home and they, and they get on my desk and move my.
[AGENT][NEUTRAL] Oh, you're fine.
[AGENT][POSITIVE] Oh, you are totally fine. I understand, no problem.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, wait a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can I also, OK, so just going back, the the plan is secondary, no network.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Only covers $700.
[AGENT][NEUTRAL] $750 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I have here she gave me that the name of the company is uh American Public Links Metlink plan.
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] OK, and the claim address for this?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] 248.
[CUSTOMER][NEUTRAL] 248
[CUSTOMER][NEUTRAL] 950. OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] And can I have your name and a reference?
[AGENT][NEUTRAL] Sure, so my name is [PII]. There's no call reference number, but you can use my name and today's date.
[CUSTOMER][POSITIVE] Thank you so much and you have a wonderful day.
[AGENT][NEUTRAL] You also, [PII], was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] No, ma'am. Thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL bye bye.
[CUSTOMER][NEUTRAL] Bye bye.