AccountId: 011433970860
ContactId: f1815902-7d26-4161-a650-4af94b93921b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 340399 ms
Total Talk Time (AGENT): 144584 ms
Total Talk Time (CUSTOMER): 176332 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/f1815902-7d26-4161-a650-4af94b93921b_20250327T17:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] like the flower, and my last initial is [PII]. I'm calling from a facility and um I have a patient who has uh American Public Life apparently has a supplemental and I just wanted to see how it works. Um, can I give you the patient's name and date of birth or would you prefer the cert number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, if you can give me all three, the patient's name, date of birth, and policy number, and I can help you with the benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect thank you so much and I apologize there is a delay on our voices we have this new phone platform.
[CUSTOMER][NEUTRAL] On our uh our computers and I'm always talking over people, so I apologize. Um, the patient's first name is the patient's first name is [PII] and the last name is [PII] um the outpatient benefit cert number on the card is 02361608.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, and then the number 8.
[CUSTOMER][NEUTRAL] And [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] OK, let me pull up that policy for us real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] And don't feel bad about your phone because I work with a phone that's a platform on the computer and I know exactly what you're talking about.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're very welcome. OK, so on [PII]'s policy, he is active. His effective date is [PII].
[AGENT][NEUTRAL] And you are correct, this is a supplemental insurance policy that's billed secondary to the primary. It helps with deductible, co-pay, and co-insurance.
[AGENT][NEUTRAL] He has, yes, he has an inpatient calendar year benefit amount of $5000 and then he has an outpatient per calendar day benefit of $500.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So on per calendar day, yeah, it's it's 500.
[CUSTOMER][NEUTRAL] 500, OK.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] If he's coming in for
[CUSTOMER][NEUTRAL] A test, a diagnostic test at one of our facilities and it's above.
[CUSTOMER][NEUTRAL] Um, that $500 threshold, that's the only thing the secondary pays out, correct?
[AGENT][POSITIVE] Correct, only up to 500.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Got you. Oh, that's interesting. It's very, that's a nice plan though to have.
[AGENT][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] OK, and um, [PII], would you mind I, I don't really see these uh these are very few and far in between, so this is not like a secondary to Medicare. He still has Blue Blue Cross commercial as his primary, is that what you're showing?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Uh, I don't see his primary insurance. Um, I can't see that information, but, um, through the group.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] This is his policy through the group so if his group, let me see if what the group has for their primary.
[CUSTOMER][NEUTRAL] So group meaning employer OK.
[AGENT][POSITIVE] Exactly. Yes, ma'am.
[AGENT][NEUTRAL] It looks like their major medical is Florida Blue.
[CUSTOMER][POSITIVE] OK, perfect. That's what I have.
[AGENT][NEUTRAL] Is that Blue Cross Blue Shield of Florida?
[CUSTOMER][NEUTRAL] Mhm, yep, so being that he has a secondary, we're not gonna um.
[CUSTOMER][NEUTRAL] We're not gonna expect anything at the time of service, um, we'll just bill it to.
[CUSTOMER][NEUTRAL] To both knowing that you guys are the secondary um.
[AGENT][NEUTRAL] Yes, that's what most, most, um, facilities do.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Alright, would you mind giving me a call reference number please?
[AGENT][NEUTRAL] Yes, ma'am, you can use my name [PII] in today's date.
[AGENT][NEUTRAL] And because you are new to this insurance, do you have the um payer ID number, the uh claims billing address, and the fax number for claims?
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Um, I'm not in the billing office, but I do see that we have a copy of the card front and back. I don't see a payer ID number, but I certainly see the, um, the claims address, phone, and fax, yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Good, good. OK, let me give you the payer ID number.
[AGENT][NEUTRAL] It's 60.
[CUSTOMER][NEUTRAL] Oh, actually it is on the card it's 60801.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Yes, ma'am, that's it.
[CUSTOMER][POSITIVE] Perfect. I just saw it. It's it's right. It was at the front of the, uh the card. I didn't even see it. All right. Well, I appreciate your time and your help. I hope you have a good afternoon.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Ms. [PII], one quick question, what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Lee Memorial Hospital.
[AGENT][POSITIVE] OK, thank you very much.
[AGENT][NEUTRAL] All right, and there's anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] No, that'll do it.
[AGENT][POSITIVE] Alright, well, you have a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you. Have a good day. Bye-bye.
[AGENT][POSITIVE] You're, you're welcome. Bye bye.