AccountId: 011433970860
ContactId: db3d2f4d-d625-47c9-9f2b-4afcfab3c6c1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 287980 ms
Total Talk Time (AGENT): 81567 ms
Total Talk Time (CUSTOMER): 178817 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/db3d2f4d-d625-47c9-9f2b-4afcfab3c6c1_20250529T16:02_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thanks for calling APL. They're speaking. May I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. How are you? Uh, my name is [PII]. Um, I don't know if you need my policy number, but I need to go to the emergency room, and, uh, United Healthcare, uh, covers or has a co-insurance of 50% after the deductible. Um, I wonder, like, everything that's in plan, will you pick up the, you know, what I have to pay as a deductible and then the co-insurance up to the maximum of your coverage?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Uh, sir, I can verify benefits for you. And what's your policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's 02611395.
[AGENT][NEUTRAL] OK, thank you, wait one moment.
[CUSTOMER][POSITIVE] You're welcome. Yes.
[AGENT][NEUTRAL] OK, and verify your date of birth, mailing address and email address for me please.
[CUSTOMER][NEUTRAL] Yes, it's, uh, [PII], uh, mailing address, uh, you probably have [PII] and the email address is, uh, which is the one I have on file maybe [PII].
[AGENT][NEUTRAL] I see a different one [PII], uh, email address.
[CUSTOMER][NEUTRAL] Oh, [PII], let me see what was my [PII] email address. Just give me one second please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you, thanks.
[CUSTOMER][NEUTRAL] Because you know I have like so many.
[CUSTOMER][NEUTRAL] Email
[CUSTOMER][NEUTRAL] Just give me, give me one second please, OK? Thank you.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And Mr. [PII], do you have a callback number in case the call drops?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes, is, uh, you can call me in, uh, in my office, uh, which is, uh, [PII] or my mobile phone number, but the office is probably better like uh [PII] or actually use this [PII].
[AGENT][NEUTRAL] OK, thank you. And you said um you're wanting to know if you have benefits for outpatient?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] Yeah, well, I, I, I'm not feeling well. I have a pain in my chest and I wanna go to the emergency room, um, and United Healthcare covers after meeting the deductible 50%, uh, coinsurance.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, you know, so, and I wanna know whether you would pick up.
[CUSTOMER][NEUTRAL] Subject to the maximum of my plan whether you would pick up the, the, you know, whatever is within United Healthcare plan that is not uh paid by United Healthcare because of the deductible and the insurance.
[AGENT][NEUTRAL] OK. Uh, yes, sir. With this policy, we are secondary, and it does help with your primary insurance deductible, co-pay or co-insurance up to your benefit max either for outpatient or in hospitals.
[AGENT][NEUTRAL] And outpatient is like ER uh yes sir.
[CUSTOMER][NEUTRAL] OK, so, and this includes the emergency room? Sorry, sorry, yeah, 000, that's the ER, OK, and what is the policy max, please?
[AGENT][NEUTRAL] OK, uh, not guarantee of payment, just a verification of coverage. You have a benefit max up to 6500 per calendar year.
[CUSTOMER][POSITIVE] Yes, of course, yes.
[CUSTOMER][NEUTRAL] OK, oh, OK, so same as my deductible in, uh, in the United Healthcare policy. So you say copay or co-insurance, and what about the deductible? You pick up the deductible too or no?
[AGENT][NEUTRAL] All three, deductible, co-pay or co-insurance, all three up to that 6500.
[CUSTOMER][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] 43. OK, I understand, but per calendar year. OK, wonderful, thank you so thank you so much. OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Uh yes, sir, and when you give them your primary insurance information, also give them our information and explain it where you're secondary, and that way they can file the claim. Yes sir.
[CUSTOMER][POSITIVE] Uh, I, I, I appreciate.
[CUSTOMER][POSITIVE] Oh yes, I, I have used that and it works very well thanks again have a good day bye bye.
[AGENT][POSITIVE] You too, thanks for calling APL. Bye.
[CUSTOMER][POSITIVE] Bye bye you're welcome bye bye bye.