AccountId: 011433970860
ContactId: db951d24-c420-42aa-9dd9-ade0d29e6769
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 432390 ms
Total Talk Time (AGENT): 132266 ms
Total Talk Time (CUSTOMER): 123661 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/db951d24-c420-42aa-9dd9-ade0d29e6769_20250422T17:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APO. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, my name is [PII]. I'm calling from Children's Service Center. I'm calling to verify a client's insurance. I'm hoping you can help me.
[AGENT][NEUTRAL] Yeah, of course, I can help you today. Let's see. Do you have the policy number?
[CUSTOMER][NEUTRAL] I do. It's 260688-9 [PII].
[AGENT][NEUTRAL] OK, yes, I do see his name. What's his date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, so it looks like this policy is active and the effective date is [PII].
[CUSTOMER][NEUTRAL] OK, um, can you tell me if he has, uh, drug and alcohol coverage, outpatient mental health coverage?
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] Of course. Give me just one moment while I pull up his certificate really quick.
[CUSTOMER][NEUTRAL] No problem. I'm just, I've never heard of it, so I'm like, um.
[CUSTOMER][NEUTRAL] Hm, how does this plan work?
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] American.
[CUSTOMER][NEUTRAL] Public.
[CUSTOMER][NEUTRAL] We don't have an American public in here.
[CUSTOMER][POSITIVE] Yes, let me get you right over to [PII]. He's a supervisor in that department. He'll be able to help you with that.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] So it's APL.
[AGENT][NEUTRAL] Uh, so this is a hospital indemnity plan.
[AGENT][NEUTRAL] Um, I am not seeing where it would cover mental health on here.
[CUSTOMER][NEUTRAL] OK, so it's a hospital plan. We are definitely not a hospital.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, so.
[AGENT][NEUTRAL] Yes, so hospital indemnity plan only covers accident and sickness.
[CUSTOMER][NEUTRAL] See hospital.
[CUSTOMER][NEUTRAL] An accident. I don't know why he thought this was medical coverage. um, what was your first name again? I'm so sorry.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] So this is a
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] So APL is a secondary medical policy to their primary.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] He, I don't even think he has a primary.
[AGENT][NEUTRAL] Um, I thought.
[CUSTOMER][NEUTRAL] Because we have nothing active for him.
[CUSTOMER][NEUTRAL] Yeah, that's how much information I was given.
[AGENT][NEUTRAL] Oh, OK. Um.
[CUSTOMER][NEGATIVE] Not much.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Is this for an office visit?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is it for a physician's office by chance?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so,
[AGENT][NEUTRAL] It does look like he has an outpatient accident and sickness benefit in a physician's office.
[AGENT][NEUTRAL] And that is $100.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] It's $100 a day.
[AGENT][NEUTRAL] Yeah, that's all I'm seeing for an office visit.
[AGENT][NEUTRAL] For this policy.
[CUSTOMER][NEUTRAL] $100 a day for the physician's office, um, [PII], is there a reference number for the call? I just wanna cover my butt.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right, um, it is [PII], my first name, and then my last initial which is [PII] and then today's date and this is not a guarantee payment, just verification of coverage.
[CUSTOMER][NEUTRAL] I am definitely going to let them know over at Sud drug and alcohol that this is a hospital and accident plan only.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. Yes, ma'am.
[CUSTOMER][NEUTRAL] But a physician's office is $100 a day, holy crap.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] See, I wonder if his Medicare is active.
[CUSTOMER][NEUTRAL] I just spotted a Medicare card.
[CUSTOMER][NEUTRAL] Um, is there a
[CUSTOMER][NEUTRAL] Payer ID.
[AGENT][NEUTRAL] Yes, there is, it is.
[AGENT][NEUTRAL] 60801
[CUSTOMER][NEUTRAL] 60801. And the claims address?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claims address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much. I hope you have an awesome day.
[AGENT][POSITIVE] Thank you. You too. Thanks for calling APL.
[CUSTOMER][POSITIVE] Have a good one.
[AGENT][POSITIVE] OK you too bye.
[CUSTOMER][NEUTRAL] Bye bye.