AccountId: 011433970860
ContactId: f12d834c-34d5-475a-a0e6-4d65a856eec4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248740 ms
Total Talk Time (AGENT): 76270 ms
Total Talk Time (CUSTOMER): 139364 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/f12d834c-34d5-475a-a0e6-4d65a856eec4_20250226T18:26_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thanks. I'm sorry, good afternoon. Thank you for calling APL. This is speaking. May I help you?
[CUSTOMER][POSITIVE] Hi good afternoon how are you doing today?
[AGENT][NEUTRAL] I'm fine, and yourself?
[CUSTOMER][NEUTRAL] I'm doing alright, thank you for asking. Um, so this is for the gap insurance, correct?
[AGENT][NEUTRAL] Um, it depends. May I ask who's calling?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] last name [PII].
[AGENT][NEUTRAL] OK, and Mr. [PII], do you have your policy number?
[CUSTOMER][NEUTRAL] Yeah, I've got a card here but I don't, I haven't gotten an updated one so I'm imagining it must be the same thing. um, what do you need from it? I've got a whole bunch of numbers here.
[AGENT][NEUTRAL] At the bottom of the card, do you see an in-hospital or outpatient benefit cert number?
[CUSTOMER][NEUTRAL] I've got uh.
[CUSTOMER][NEUTRAL] I have an in hospitals benefit card. I have an outpatient benefit card number and I have a um.
[CUSTOMER][NEUTRAL] A plan
[AGENT][NEUTRAL] OK, what's the, um, what's the outpatient patient number?
[CUSTOMER][NEUTRAL] And a group number.
[CUSTOMER][NEUTRAL] OK, 01699652ML8.
[AGENT][NEUTRAL] OK, thank you. And verify your date of birth, mailing address and email address, please.
[CUSTOMER][NEUTRAL] Yeah, [PII]. Uh, the mailing address is [PII], and the email address is probably my work address, [PII].
[AGENT][NEUTRAL] Uh, what's that one more time because I don't show it. You said it's [PII].
[CUSTOMER][NEUTRAL] If, if, if, if, if it's not well it's not [PII] then maybe it's [PII].
[AGENT][NEUTRAL] Well, I don't show either email address. Which one would you prefer for us to have in the system?
[CUSTOMER][NEUTRAL] 00, put, put my work on [PII]
[CUSTOMER][NEUTRAL] At [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] So it's
[CUSTOMER][NEUTRAL] So it's basically my first name.
[CUSTOMER][NEUTRAL] At [PII].
[AGENT][NEUTRAL] OK, and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and Mr. [PII], how may I assist you today?
[CUSTOMER][NEUTRAL] So just really quick because I'm I'm in [PII] here. I'm about to put gas. I went to the doctor and, and there's a, uh, there's a gap in terms of what's not being covered by my insurance, my primary insurance, and so I wanted to see if, if you guys could pick up that difference. And so how would I need to go about doing that? Do I just go ahead and pay the medical provider and then submit it to you guys, or I should I submit the bill to you guys first to see if you cover it and then and see what happens?
[AGENT][NEUTRAL] Well, uh, with your policy, um, it does not cover any office visits nor procedures in office, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All it covers for outpatient or in hospital.
[CUSTOMER][NEUTRAL] Uh, OK, so what?
[CUSTOMER][NEUTRAL] So, so, um.
[CUSTOMER][NEUTRAL] OK, so like if I went to see the doctor and they did a procedure that's not covered, it would only cover if it was something that was done in the hospital.
[AGENT][NEUTRAL] Or outpatient.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Outpatient
[CUSTOMER][NEUTRAL] For either an out.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Outpatient in the hospital or or uh.
[CUSTOMER][NEUTRAL] Or, or being in the hospital is the state. Now I don't know if if if it's done like at at the medical clinic at the hospital. I don't know if if that constitutes outpatient or not. I mean, would, would it be possible to, I guess it depends on the billing, is that correct?
[AGENT][NEUTRAL] Well, it depends on the place of service. Well, it would not be covered in a clinic or in a doctor's office. Outpatient is ER, urgent care, ambulatory surgery center, MRI or imaging center.
[CUSTOMER][NEUTRAL] The way they built
[CUSTOMER][POSITIVE] Oh, OK, OK, I see. OK, alright, thank you very much. I'm gonna have to, I'm gonna have to get back to you because I gotta get out of the car and not the gas, but thank you so much. I appreciate it.
[AGENT][POSITIVE] Oh yes, sir. Thank you for calling APL. You have a great day.
[CUSTOMER][NEUTRAL] OK, OK, OK, bye bye.
[AGENT][NEUTRAL] Bye.