AccountId: 011433970860
ContactId: d49b644d-8f49-4762-9e2f-a1e893ebd118
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248479 ms
Total Talk Time (AGENT): 102638 ms
Total Talk Time (CUSTOMER): 144201 ms
Interruptions: 7
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/d49b644d-8f49-4762-9e2f-a1e893ebd118_20250528T14:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII]. I'm calling from Coral Ridge. I'm trying to verify benefits please.
[AGENT][NEUTRAL] You're calling from where again?
[CUSTOMER][NEUTRAL] Coral Ridge Outpatient center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Can you spell your name for me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] spell your name?
[AGENT][NEUTRAL] Um, [PII], last initial [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] So what I have in here is.
[CUSTOMER][NEUTRAL] 02465388 ML 8.
[AGENT][NEUTRAL] OK, one moment while I look that up for you.
[CUSTOMER][POSITIVE] Sure, no problem.
[AGENT][NEUTRAL] And can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] It is [PII]. I'll spell the last name is [PII] Date of birth [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] And you wanted benefits and eligibility, correct?
[CUSTOMER][POSITIVE] Yes, yes, I do.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So this is a Medlink policy. It's secondary gap insurance. It looks like we have an effective date of [PII], and the policy is currently active.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm, OK, and what do they pay? um how does the benefit because the patient has an amount to pay with the primary insurance?
[AGENT][NEUTRAL] Yeah, so when filing a claim for this insurance.
[CUSTOMER][NEUTRAL] So do you guys cover mhm.
[AGENT][NEUTRAL] It'll have to go through primary first and if primary uh denies the denies the claim, then this one will deny the claim as well. It only picks up afterwards. Let me see.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] That's what my uncles grandma always thinks that she makes it.
[CUSTOMER][NEUTRAL] To the cherry like it's different than the one from here.
[CUSTOMER][NEUTRAL] So the patient would have to pay the whole whatever amount it's due on the day of?
[AGENT][NEUTRAL] Um, no, it shouldn't. It'll go through their primary insurance first.
[CUSTOMER][NEUTRAL] Verification the payment plan.
[CUSTOMER][NEUTRAL] Right, right, so no, so, so that's what I'm saying because she has a payment due with the primary insurance, so she's under the assumption that if with this insurance they would pick up the amount because it's like 1,000+.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] I need somebody else.
[AGENT][NEUTRAL] Um, no, if
[AGENT][NEGATIVE] If the primary didn't pay anything then this one won't um.
[CUSTOMER][NEUTRAL] A grandma brought me one.
[AGENT][NEUTRAL] Let me check and see, did she file a claim with her primary first and they denied it?
[CUSTOMER][NEUTRAL] No, no, the, the procedure hasn't been done yet. The procedures on the 2nd, so that's why I'm a little confused. So you guys pick up whatever she needs to pay on the primary insurance? That's what I'm, that's my question. It's.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] We pick up after the primary insurance, um.
[CUSTOMER][NEUTRAL] Like orangeish and then the red.
[AGENT][NEUTRAL] So it's gap policy, so the primary will have to pay first and then when the primary pays, you'll get an EOB from them and then you'll send that in with the claim for this policy because they have to have certain benefits paid first.
[CUSTOMER][NEUTRAL] and
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, so she would have to pay.
[CUSTOMER][NEUTRAL] OK, um, can I get a reference number please?
[CUSTOMER][NEUTRAL] How can I help you?
[AGENT][NEUTRAL] Sure, we don't have reference numbers, but you can use my name and last initial in today's date, so [PII] in today's date.
[CUSTOMER][POSITIVE] All right, no problem, thank you so much.
[AGENT][POSITIVE] OK. Thank you for calling APL and have a great day.
[CUSTOMER][NEUTRAL] Recovery line 1 recovery.