AccountId: 011433970860
ContactId: b1f3bce9-9ad9-4de4-932a-af7bb965128c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217940 ms
Total Talk Time (AGENT): 118657 ms
Total Talk Time (CUSTOMER): 68854 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/b1f3bce9-9ad9-4de4-932a-af7bb965128c_20250214T13:40_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] Uh, yes, can you verify eligibility.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh yes, my name is [PII]. Direct line is [PII].
[AGENT][NEUTRAL] OK, and the phone kind of went in and out. Did you say your name was [PII]?
[CUSTOMER][NEUTRAL] [PII], I'm sorry.
[AGENT][NEUTRAL] [PII], OK. It's OK. And [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] Um, 02435048.
[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] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active, it's been effective since [PII] of
[AGENT][NEUTRAL] I'm sorry, [PII].
[AGENT][NEUTRAL] And did you want to go over any benefits or you just needed the eligibility date?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Is that through her employer?
[AGENT][NEUTRAL] Yes, this is through her employer.
[CUSTOMER][NEUTRAL] OK, and so, um, do you show that your primary to Blue Cross Blue Shield her husband's got.
[AGENT][NEUTRAL] Well, this is a hospital indemnity policy, so if she does have a major medical, then yes, this would be second to whatever is major.
[CUSTOMER][NEUTRAL] Oh, OK, so it's like a just, OK, supplemental for major major medical.
[AGENT][NEUTRAL] Well, not really supplemental to major. It's just because the hospital indemnity is a limited medical policy, it can't go before a major.
[CUSTOMER][NEUTRAL] Can you
[CUSTOMER][POSITIVE] Got you OK.
[CUSTOMER][NEUTRAL] So it does pay secondary to spouses it just for hospital charges or?
[AGENT][NEUTRAL] Um, so she has a hospital admission benefit. So there is a benefit if she's admitted or confined to the hospital, um, ICU or rehab. Um, there's also a surgery benefit for facility or, or I'm sorry, facility or physician office, but then there's also like emergency room, urgent care, physician office visits, physical therapy, diagnosis um diagnostic testing.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][POSITIVE] So there is a few other benefits to it, not just hospital.
[CUSTOMER][NEUTRAL] OK, so even if we like if it's accident related possibly.
[AGENT][NEUTRAL] Well, there are benefits for if there, for if it is accident related, so it's really accident and sickness. So whether whatever she's being seen for, if it's an accident or fall in the accident, if it's sickness, it's still the same benefit just depending on what she's there for.
[CUSTOMER][NEUTRAL] OK, but, um, spouse was being major medical we need that needs to be filed first.
[AGENT][NEUTRAL] You said a spouse is breaking up again. You said a spouse.
[CUSTOMER][NEUTRAL] Oh, I'm sorry. The, the spouse is planned through Blue Cross Blue Shield as being major medical, that should be filed first.
[AGENT][POSITIVE] Oh, yes, that's correct.
[CUSTOMER][NEUTRAL] And then you guys
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, just wanna make sure thank you so much. What was your name again?
[AGENT][NEUTRAL] My name is [PII] and the first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Thank you have a great day.
[AGENT][POSITIVE] You also, [PII], and thanks for calling APL. Have a great weekend.
[CUSTOMER][POSITIVE] You too thanks bye bye.
[AGENT][POSITIVE] Thank you, bye bye.