AccountId: 011433970860
ContactId: c4f8cbc9-befe-46cf-9406-213747502672
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 547710 ms
Total Talk Time (AGENT): 186056 ms
Total Talk Time (CUSTOMER): 254010 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/c4f8cbc9-befe-46cf-9406-213747502672_20250129T14:52_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes ma'am um my name is [PII]. I work for Liberty Doctors, um, and the office manager emailed me and I think I got this right, I guess she just has a couple questions, um, and I think what she our office manager I guess this is an she's an established patient.
[AGENT][NEUTRAL] OK, who emailed to?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um, I, and I'm a little confused in this, but what my office manager is asking is what is this plan, um, her insurance card, I guess she's trying to figure out if it's a high deductible, and, um, I guess who you're maybe associated with like a signal or are you signal plan or Blue Cross Blue Shield or Aetna.
[AGENT][NEUTRAL] OK, so [PII], you're calling on behalf of your supervisor?
[CUSTOMER][NEGATIVE] I'm a little confused.
[CUSTOMER][NEUTRAL] Right, but I work for the provider, I'm one of the billers and we're just trying to figure out some information.
[AGENT][NEUTRAL] Do you have a
[AGENT][NEUTRAL] Do you have the policy number?
[CUSTOMER][NEUTRAL] Mhm, absolutely, uh, give me like 2 seconds sorry.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] My computer's a little slow today.
[AGENT][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] Um, OK, so it is D as in dog 45401551.
[AGENT][NEUTRAL] Spell her first and last name.
[CUSTOMER][NEUTRAL] It is [PII] and the last name is [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry, I tried to Googling this the other day and I couldn't come up with any information and it's not a plan that I'm familiar with.
[AGENT][POSITIVE] Oh, no problem.
[CUSTOMER][NEUTRAL] And I even asked somebody who has more experience in the office and she didn't know either.
[AGENT][NEUTRAL] Give me one moment.
[CUSTOMER][POSITIVE] Oh, no, take your time.
[AGENT][NEUTRAL] And you're calling from a medical provider's office?
[CUSTOMER][NEUTRAL] I am. I have an MPI. I have a tax ID. You tell me what you need.
[AGENT][NEUTRAL] Hm, that's OK. Yeah, I was looking for the policy number and I have it. The D number is for 90 Degrees. They're a different company. Um, the medical policy is with the, with APL, American Public Life, which is who you're speaking with, and you may want to jot down this policy number.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 0258.
[AGENT][NEUTRAL] 0841.
[AGENT][NEUTRAL] And what type of service is it for?
[CUSTOMER][NEUTRAL] OK, um
[CUSTOMER][NEUTRAL] It it's medical.
[AGENT][NEUTRAL] I mean, is it an office visit?
[CUSTOMER][NEUTRAL] So the policy.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so this is, this is a limited hospital indemnity policy. There is an office visit benefit under this plan. Did you want that benefit?
[CUSTOMER][NEUTRAL] Um, yes, but I do have a question. The, uh, policy number that you just gave me, is that for the office number because that's not what's on the, um, I.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The card that she presented the insurance card.
[AGENT][NEUTRAL] Yeah, the D number is unique to 90 degrees. Their name should be on that card somewhere 90 degree.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] And they may provide like a wellness benefit, so it's a valid number.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] But then they have a medical policy with American Public Life, that, that number may not be, the number that I gave you may not be on that card.
[CUSTOMER][NEUTRAL] Um, actually I told you incorrectly, so I don't know how they came up with the D number because I'm looking at the card now and I apologize, but the number that you gave me the 02580841, when I did was able to pull up the card, that's the number so I don't know how they came up with the D number so the D number is just for 90 degrees and I wouldn't file claims there. I'm gonna follow it to the one.
[AGENT][NEUTRAL] 250, 25.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That you gave me that.
[AGENT][NEUTRAL] Right, so the, so the, so it's two different companies, 90 Degrees perhaps may offer some type of a wellness benefit.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And their number, their unique number does begin with a D, that number that you gave me before, so it's a valid number for 90 degrees. And then American Public Life, which is who you're speaking with, we have a medical policy for this patient for this insured, and our number is different. We have our own unique policy number.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, I got it straight now I'm sorry, um.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I haven't been doing this too long. I don't see all this kind of stuff, so I apologize, um, OK, and so what she's trying to figure out is, um, I guess is there a copay, is there a high deductible?
[AGENT][POSITIVE] No worries, no worries.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So because it's, it's a limited hospital indemnity plan, so this plan pays a certain benefit for a type of service. So if this is for service in a primary care or a specialist office, the policy will cover up to $100 of covered charges per day.
[CUSTOMER][NEUTRAL] OK, up to.
[AGENT][NEUTRAL] And then the maximum number of days per calendar year are 4.
[CUSTOMER][NEUTRAL] OK, um, and up to.
[AGENT][NEUTRAL] 4 per calendar year.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] Sorry, I'm just making notes.
[AGENT][NEUTRAL] I know, that's OK.
[CUSTOMER][NEUTRAL] OK, so you'll pay up to $100 per day or per visit, no per day uh for a visit.
[AGENT][NEUTRAL] Per, uh-huh, per day.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, and then um they can have 4 appointments per calendar year.
[AGENT][NEUTRAL] Correct. And that's just not specific to to one doctor. So, you know, they could see this office and then they may have a, she may have an appointment with another specialist. So it's not for per provider, it's for collectively, just 4 visits per calendar year. Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, specialist.
[CUSTOMER][NEUTRAL] And PCK OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'm gonna put all that's OK, but there's no like and then they'd be the patient would be responsible for the difference.
[AGENT][NEUTRAL] We do not determine patients responsibility and we just basically provide you the benefit that's covered under their plan for a type of service.
[CUSTOMER][NEUTRAL] OK, um, and but there's no copay or co-insurance or deductible, OK.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No, no, we just pay up to $100 for the total charge of the office visit.
[CUSTOMER][NEUTRAL] OK, copay.
[AGENT][NEUTRAL] And of course information provided is verification, not a guarantee of payment.
[CUSTOMER][NEUTRAL] No coinsurance.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][POSITIVE] OK, I think that's all she needs to know if not I'll have to call back but thank you so very much. I appreciate that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You, you're welcome, [PII]. Any other questions?
[CUSTOMER][NEUTRAL] No, uh, can I just have your name so that I can show that I did actually call?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure, you, you'll use my name in today's state as your reference, [PII]
[AGENT][NEUTRAL] And first initial of my last name is [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, yeah, I was completely lost in that, so thank you very very much.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] All right have a good day bye.
[AGENT][NEUTRAL] Bye-bye.