AccountId: 011433970860
ContactId: ef2f6b8e-8358-46ad-815b-43955d4dbabe
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 325359 ms
Total Talk Time (AGENT): 146953 ms
Total Talk Time (CUSTOMER): 128454 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/ef2f6b8e-8358-46ad-815b-43955d4dbabe_20250131T15:17_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. I got a quick question. I got a bill from Baptist Health. Let me give you my
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Group number I guess ID number you tell me what you need.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, the policy certificate, which it's gonna be in the bottom where it says outpatient start number.
[CUSTOMER][NEUTRAL] Lala, it is 02464248 M as in Mary, L as in Larry, 8 as the number 8.
[AGENT][NEUTRAL] OK, and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Absolutely. [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and may I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And may I have your date of birth, Miss [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and one last thing, may I have the mailing address on file for verification?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, the whole thing, uh, [PII], it's actually [PII].
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] OK, yep, thank you. All right, and let's see.
[AGENT][NEUTRAL] What is the date of service for that bill? Let me check and see if you received it.
[CUSTOMER][NEUTRAL] It's me
[CUSTOMER][NEUTRAL] OK, I, I think it's [PII] or [PII].
[AGENT][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] One of the two, the bill says [PII], but the, the bill says [PII], but I remember it happening on the [PII], so I mean it doesn't really matter that's that's 2 or 3 days.
[CUSTOMER][NEUTRAL] It it should matter but it doesn't matter I guess.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] All right. And how much are they charging you?
[CUSTOMER][NEUTRAL] They're charging me $1500.
[AGENT][NEUTRAL] Oh boy. Hmm. OK, let's see.
[AGENT][NEUTRAL] Let me check and see your benefits.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] But it's a gap insurance. I don't understand like I told her I said I'm sorry that I've never, I, I in the past, I never had this issue.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, um,
[AGENT][NEUTRAL] Let me check.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 24.
[AGENT][NEUTRAL] And it used to be in the.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I see what happened. All right, um, so, uh, when we got the claim, um, the claim had um.
[AGENT][NEUTRAL] The amount applied towards the deductible and it was 3000 applied towards the deductible. Um, this policy pays 1500 per day.
[AGENT][NEUTRAL] So we send the $1500 per day benefit, but it looks like you still have that remaining balance.
[CUSTOMER][NEGATIVE] OK, and I'm not getting it. What, what is, what does that mean? I mean, at the end of the day it's.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You still owe that balance of 1500.
[CUSTOMER][NEUTRAL] Aren't you guys supposed to cover?
[AGENT][NEUTRAL] Because we pay
[CUSTOMER][NEGATIVE] Aren't you guys supposed to cover the whatever the insurance doesn't cover? Isn't that what my, my gap insurance is supposed to be?
[AGENT][NEUTRAL] We pay
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] We pay up to the maximum benefit of the policy.
[AGENT][NEUTRAL] The maximum benefit of this policy is 1500 per day.
[CUSTOMER][NEUTRAL] And how much?
[AGENT][NEUTRAL] 1500 per day.
[CUSTOMER][NEUTRAL] Per day.
[AGENT][NEUTRAL] Mhm. Yes.
[CUSTOMER][NEGATIVE] So if I would have stayed overnight, you would have paid the other one, you would have paid another 1500.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] If you would to stay overnight, it would have been under the inpatient instead of the outpatient. Anything 18 hours or more is considered inpatient. The inpatient benefit is $2000.
[AGENT][NEUTRAL] Per current.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Alright, and let me ask you, is that is this policy still active right now?
[CUSTOMER][NEUTRAL] I know that in February sometimes it changes. I just wanna make sure it's active right now.
[AGENT][NEUTRAL] OK, let me check.
[AGENT][NEUTRAL] Yeah, as of right now I don't see any changes and it's active, correct, mhm.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] OK, no, because I haven't gotten the new card, so I just wanna make sure that, yeah, so I'll go ahead now active 225.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] To and that's the same way it works now this this year correct?
[AGENT][NEUTRAL] Correct. I don't see any changes, so that means that the policy number will not change and um you still have the same benefits. So everything is gonna still be the same for this coming year.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Great, great. Thank you so much. You have a beautiful day.
[AGENT][POSITIVE] You're welcome. You as well. Is there anything else I'm gonna help you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, that's it. I appreciate it. Thank you. All right. Bye.
[AGENT][POSITIVE] OK. You're welcome. Have a good day. You're welcome. Bye-bye.