AccountId: 011433970860
ContactId: ee26d6c9-86ae-40d6-980b-82e6285c46be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 461720 ms
Total Talk Time (AGENT): 238271 ms
Total Talk Time (CUSTOMER): 179105 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/ee26d6c9-86ae-40d6-980b-82e6285c46be_20250219T14:33_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] We see here.
[CUSTOMER][NEUTRAL] Uh, this is [PII].
[CUSTOMER][NEUTRAL] And what, what do I, what information do I need to give you the.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Uh, do you have your policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, let me look here. Hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] that this is not going anywhere. Anything that melts will be for you or you're not at zero, but it feels that way in some spots. You'll notice they're coming around the square. I think they're looking really nice. It's coated in that snow.
[CUSTOMER][NEUTRAL] OK, it looks like policy numbers.
[CUSTOMER][NEUTRAL] 248-2009
[AGENT][NEUTRAL] OK. 248-2009.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] OK, and verify your date of birth, mailing address and email address for me, please.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] [PII] and what else do you want?
[AGENT][NEUTRAL] Uh, mailing address and your email address, please.
[CUSTOMER][NEUTRAL] Uh, mailing address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And your email address? Yes, sir.
[CUSTOMER][NEUTRAL] My email is.
[CUSTOMER][NEUTRAL] It's uh [PII].
[CUSTOMER][NEUTRAL] My last name [PII], [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, awesome. And your good callback number is [PII] if the if the call gets disconnected?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, and how may I assist you today, Mr. [PII]?
[CUSTOMER][NEUTRAL] Um, my wife is gonna have surgery, uh.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I just uh I don't know what what to do or I've never used this.
[AGENT][NEUTRAL] OK, uh, what, what's
[CUSTOMER][NEUTRAL] Before and I've had it for a long time, but.
[AGENT][NEUTRAL] Yes, sir. Oh, with this policy, it's a secondary plan. Uh, what it does, it helps with your major medicals, deductible, co-pay or co-insurance for services inpatient or outpatient. Um, I would say when you give them her primary insurance information, also give them our information as secondary, that way they can call and verify benefits and eligibility. Um, is she supposed, is this surgery is going to be inpatient or outpatient?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It'll be outpatient surgery.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] She broke her arm, but.
[AGENT][POSITIVE] Oh, I'm sorry. I hope she's recovering well.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I hope she will recover well.
[CUSTOMER][NEUTRAL] Yeah, she's laying down.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[CUSTOMER][NEUTRAL] But uh so.
[AGENT][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] I don't know how, how do I go about this when I go in there because uh.
[AGENT][NEUTRAL] Um, and do you, I'm assuming you have a copy of your card?
[CUSTOMER][NEGATIVE] No, I don't, no.
[AGENT][NEUTRAL] OK. Um, if you like, I can have your card emailed to you. That way you can have a copy that shows the, um,
[AGENT][NEUTRAL] Provider, the hospital, um, the surgeon, and when you give them your primary insurance information, because when you give them our card just
[CUSTOMER][NEUTRAL] Yeah my primary is.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm my primary is at at.
[AGENT][NEUTRAL] OK. Yes, sir. And you just give them our information as your secondary.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] What is what is a secondary cover or?
[AGENT][NEUTRAL] Well, so this is how it works. So after your primary insurance has processed the claim, if they apply any amount towards deductible, co-pay, or co-insurance, that's what we pick up as secondary up to your max benefit and um not a guarantee of payment, just a verification of coverage. You have an outpatient benefit that pays up to $3000 per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, let's say for the facility, um she has the procedure, they build the primary, the primary applies $200 towards the deductible, that's uh or $2000. That's what we pick up and pay up to that $3000 benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, so it's it's $3000.
[AGENT][NEUTRAL] Yes, sir, for outpatient or in hospital. Um, would you like me to email this to you that way you can have a copy to show the provider?
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][POSITIVE] Yes ma'am, if you could.
[AGENT][NEUTRAL] OK, I will send this to you.
[AGENT][NEUTRAL] OK. And is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Well, just be like a like a card it'll will have my name and my wife's name on it.
[AGENT][NEUTRAL] Well, it would just have your name, but it would show a couple's policy.
[AGENT][NEUTRAL] A show employee and spouse and what normally happens is the billing department will for the hospital physician will contact our office to verify benefits and we just verify the benefits just like I gave to you and um let them know this is secondary, that way, as soon as the primary process the claim, they'll know to send it to us as secondary to process.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Alright, uh, that'll work. I, I've never used it, so I don't quite sure how, how to go about it.
[AGENT][NEUTRAL] I know, I understand, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I was also gonna let you know.
[CUSTOMER][NEUTRAL] I figured when I enrolled through the company.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I figured when I, I figured when I enrolled through the through the company I work for, I figured to give me cards on everything I got, but the only card I got is [PII].
[AGENT][NEUTRAL] Yeah, you should have received your card. I'll also send a request to have it mailed out to you, OK?
[CUSTOMER][NEUTRAL] OK, yeah, if you could mail it and email it to me.
[AGENT][NEUTRAL] OK. Um, and we do have an online service center to where you can view your policy and also it can give you um an alert when a claim has been received and when it's been processed.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I've seen that on there when I because I.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I made a, you know, the.
[CUSTOMER][NEUTRAL] I created a user ID and password on there.
[AGENT][POSITIVE] OK, good deal. And you can also view your policy if uh if you like to know what your benefits are and how the policy works.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alrighty, well, I think that's pretty much all I need is just uh you're gonna email that to me though.
[AGENT][NEUTRAL] Uh yes, sir. I'm gonna email it right now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] No, ma'am, I think that'll do it.
[AGENT][POSITIVE] All right. Well, I thank you so much for calling APL. You have a great day. If you think of any other questions, just give us a call, OK?
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][POSITIVE] Yes, sir. Thank you for calling APL.
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][POSITIVE] Uh huh bye-bye. Have a nice day. Bye-bye.
[AGENT][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] Oh