AccountId: 011433970860
ContactId: b93a7c18-cd1b-417b-ab5f-892c21815c51
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 310630 ms
Total Talk Time (AGENT): 137378 ms
Total Talk Time (CUSTOMER): 138608 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/b93a7c18-cd1b-417b-ab5f-892c21815c51_20250221T19:10_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, um, I have this, uh, gap insurance and I used it one time before, but I don't know what all was covered under that and someone mentioned to me that um.
[CUSTOMER][NEUTRAL] I had to be taken by rescue to the emergency room. Is that something that's covered with your gap insurance?
[AGENT][NEUTRAL] Um, I can definitely take a look at your coverage and see, um, so you're saying you were taken by the ambulance to the emergency room?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I can check for you. Um, may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] My name is [PII]. The last name is [PII]
[AGENT][NEUTRAL] All right, and then a good contact number in case we're disconnected and your policy number.
[CUSTOMER][NEUTRAL] 904-7081134
[CUSTOMER][NEUTRAL] Alright, so I have my card in front of me. The policy number is I have a group number. I have a plan name and I have a in hospitals benefit cert number and an outpatient benefit cert number.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, um, either the outpatient or in inpatient, the numbers are the same, that ML 7 or 8 at the end is different. I just need the numbers.
[CUSTOMER][NEUTRAL] OK, 023041997.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] OK, so I have you here and I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Uh, so my date of birth is [PII]. My mailing address is [PII], and then you said email on file I think is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And let me take a look at your benefits. Hold on one moment.
[AGENT][NEUTRAL] OK, so for outpatient, your policy will pay up to $1500 per person per calendar year. It includes both the hospital emergency room and the ambulance.
[CUSTOMER][NEUTRAL] Alright, so I just submit that bill to y'all as it claims and then y'all pay it, is that how that works?
[AGENT][NEUTRAL] Well, you have two options. How long ago, like was this recent?
[CUSTOMER][NEUTRAL] At the beginning of December.
[CUSTOMER][NEUTRAL] But I was told by our insurance person that you could I can still file it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, you can. The reason I'm asking this is because depending on the time I was gonna say, you can possibly just call the provider and say, hey, I have this secondary insurance, here's the policy number and they bill us or you can still, you can file the claim yourself too. I was just giving you the other option.
[CUSTOMER][NEUTRAL] All right, um.
[AGENT][NEUTRAL] But now
[CUSTOMER][NEUTRAL] My the bill is at home and I'm at work. So let me, let me try the, uh, calling, it's Baptist Hospital and I'll call them first and see if they can do that. And then if not, then I'll call you. I can submit it online, right? The claim online?
[AGENT][POSITIVE] Yes, you can submit it online, um, you can fax it or you can mail it. Um, once, when you give them a call, you can also give them our phone number if they need to verify benefits with us, but typically you just give them a call, let them know you have a secondary insurance and give them that information and they'll go ahead and bill it um because if they had it, they would have billed it. So they they usually just go ahead and bill it for you. So I I hope you don't have any trouble.
[CUSTOMER][NEUTRAL] I went by rescue. I wasn't really thinking about much of anything and I forgot all about my gap insurance.
[AGENT][NEUTRAL] Well, no, that's totally fine. Um, I'm just saying if they, they have the ability to add your insurance and um bill it for you. I just hope, you know, depending on the physically sometimes they do give a hard time, so I hope you don't have that.
[CUSTOMER][NEGATIVE] Well, we have open enrollment and so we were, you know, of course, they're, they're wanting to, you know, there's, my company pays for this gap insurance and I had forgot about it and I'm like, oh, it's too late now. They're like, no, it's not. I like, I, I, you know, I didn't was not in the, in the frame of mind at the time that I'm thinking what kind of insurances do I have? You know what I'm saying? I just was like, didn't care.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] And.
[CUSTOMER][POSITIVE] So I'm glad that that I profile. That's really good to know.
[AGENT][NEUTRAL] Yes, ma'am, and your policy has been active since [PII]. So really, since there's no timely filing limit, even if you had claims from back in [PII], you could still file.
[CUSTOMER][POSITIVE] Oh wow. All right. That's good to know as well.
[CUSTOMER][POSITIVE] Alright well I thank you very much for your help and like I said I'll contact them first and just tell them I have a secondary insurance and if if that doesn't work then I'll contact y'all.
[AGENT][NEUTRAL] Alright, well, was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] That's it thank you very much.
[AGENT][POSITIVE] You're very welcome. Well, thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.