AccountId: 011433970860
ContactId: d3670b36-2101-4080-9e9c-770f6c3595bb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206320 ms
Total Talk Time (AGENT): 84434 ms
Total Talk Time (CUSTOMER): 99981 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/d3670b36-2101-4080-9e9c-770f6c3595bb_20250122T21:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. My name is [PII] and I have the gap insurance, and I was just wanting to know, uh, I had some X-rays and it was out of network. I didn't know, and they were $300. I hadn't got the final bill yet. I just noticed on my insurance app. So is that something I can file under GAP or not?
[AGENT][NEUTRAL] I will have to check to see which policy that you have with us. May I have that policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am, it's uh 02565559.
[AGENT][NEUTRAL] And Ms. [PII], could you please verify your date of birth and the mailing address?
[CUSTOMER][NEUTRAL] Yes, ma'am. It's [PII] and mailing address is [PII].
[AGENT][NEUTRAL] And may I have a callback number just in case this call is disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[AGENT][NEUTRAL] And it does like we have an email address on file. Could you verify that for me?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][POSITIVE] And thank you so much Ms. [PII] for verifying your policy. You were calling in regards to some services that was rendered. Is this within an outpatient facility or an office setting?
[CUSTOMER][NEUTRAL] Well, it was like it was Lafayette Imaging. I went to a doctor in the same building and he sent me to the imaging for the X-ray, and he was covered, so I pay the copay, but the, the, uh, imaging center I guess was out of network for my insurance.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so with this policy we will pay towards your primary insurance deductible, co-insurance or co-pay. So if they apply it to one of those categories and it is submitted in as an outpatient benefit, then you do have that benefit listed on here.
[CUSTOMER][NEUTRAL] Oh, OK, because yes ma'am I think it's going towards my deductible, but I'll make sure once I get the final bill and know exactly how much I will, uh, I think that's what it's doing since they're not paying because it was out of network, but so then I just need to, uh, I need to call back or do I need to go online to file a claim or how do I need to do that?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now if you would like to file the claim, you can submit the EOB and a statement for that date of service via the portal online, fax or mail or you can have the primary to submit that information once your primary, well, you can have the provider to submit that information once the pri primary completes their claim.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Pro.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So you have, you have an app or it's just the online portal that.
[CUSTOMER][NEUTRAL] That I can pull up.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] It's just a portal.
[CUSTOMER][NEUTRAL] Just the portal. OK, alright, I think I registered last year because I had coverage last year but didn't have to use it. OK, thank you, ma'am.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] You're welcome and I wanna thank you so much for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye.