AccountId: 011433970860
ContactId: f23b7f65-1f12-47df-82d3-f79336fcb8ec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 405179 ms
Total Talk Time (AGENT): 107000 ms
Total Talk Time (CUSTOMER): 180810 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/f23b7f65-1f12-47df-82d3-f79336fcb8ec_20250407T17:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. How are you?
[AGENT][POSITIVE] Good how are you?
[CUSTOMER][NEUTRAL] I'm good. [PII], I'm calling you from a facility um named Upton Regional Medical Center. I'm following up on um a member that um kind of, kinda not belongs to benefits and a card or 90 degree benefits. They had sent, um, they had faxed over some information. The patient didn't have medical coverage with them, so they said they faxed this information to you guys.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Exactly
[CUSTOMER][NEUTRAL] I'm not quite sure what your involvement is with this. So I was just wondering if you received the patient's information.
[AGENT][NEUTRAL] OK, [PII], I can look into that for you. Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] I do. It's D as in David, 476-885-11.
[AGENT][NEUTRAL] And.
[AGENT][NEUTRAL] And what is the last name of the patient?
[CUSTOMER][NEUTRAL] Um, [PII]
[AGENT][NEUTRAL] First name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And [PII], can I get a good callback number for you?
[CUSTOMER][NEUTRAL] Certainly. [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Um, OK, did they indicate what type of plan it was like a hospital indemnity or?
[CUSTOMER][NEUTRAL] Medical coverage?
[AGENT][NEUTRAL] Medical cover, OK, let's see. I've got.
[AGENT][NEUTRAL] A few different policies here. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, do you have his date of birth?
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] It's um
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, um, are you needing benefits? Is that what you're needing?
[CUSTOMER][NEUTRAL] Yeah, I already spoke with someone from um the 90 degree uh benefits, and they said the patient didn't have medical coverage. They're also known as benefits in a card, I don't know. Um, and then they faxed the information to you guys.
[CUSTOMER][NEGATIVE] Because this patient had no coverage. I'm not quite sure.
[AGENT][NEUTRAL] Well, I've got
[CUSTOMER][NEUTRAL] What's happening here?
[AGENT][NEUTRAL] Yeah, I've got a, this, this policy is like a supplemental policy. It's a hospital indemnity plan.
[AGENT][NEUTRAL] Um, through that employer benefits in a card, um,
[AGENT][POSITIVE] So, um, I can give you the benefits for that. It's an active policy. I show the policy is active.
[CUSTOMER][NEUTRAL] Active
[AGENT][NEUTRAL] Effective [PII].
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] [PII]. So my date of service is [PII]. And what's the name of the insurance?
[AGENT][NEUTRAL] Um, so it's we're American Public Life.
[CUSTOMER][NEUTRAL] American.
[CUSTOMER][NEUTRAL] Public life, OK.
[CUSTOMER][NEUTRAL] Um, so if I have a bill for this patient, where would I send our bill?
[AGENT][NEUTRAL] Um, we've got an, uh, payer ID claims mailing address, and a fax. Which one would you like?
[CUSTOMER][POSITIVE] Oh, I would love the facts.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Fax is 877.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 3659423.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 423 fax. OK, perfect. So I could just fax that over today. If I am still within the time frame.
[AGENT][NEUTRAL] Um, so there's no timely filing on this policy, and it, like I said, it is a supplemental policy, so it pays a certain dollar amount for certain types of services. It's not like a major medical.
[CUSTOMER][NEUTRAL] I'm hoping.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So let me see what type of service this is.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Clinic outpatient? Hold on now.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] He just had an ultrasound. I only have a bill for an ultrasound.
[AGENT][NEUTRAL] OK, is that in the outpatient hospital facility?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, let me look at the benefits.
[CUSTOMER][NEUTRAL] All right. I'll send it. Whatever happens happens. If not, yeah, if, if not, I guess the patient would be responsible.
[AGENT][NEUTRAL] Um, yeah, we don't determine patient responsibility, um, since it's a supplemental policy, so.
[CUSTOMER][NEUTRAL] Is that how this works?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. So, we'll, I'll fax it over and let's see what happens after that, um, with, with all our details on there and then you'll send us.
[CUSTOMER][NEGATIVE] I guess by mail you guys, yeah, because I'm not gonna send it electronically.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, we send an explanation of this.
[CUSTOMER][POSITIVE] OK, sounds good. All right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That sounds good to us. All righty. So, um,
[CUSTOMER][NEUTRAL] I'll send you the bill. What else do I need? I think that that's all. Maybe a reference number?
[AGENT][NEUTRAL] Uh, reference number is just my name, [PII], first initial, last name, [PII], and today's date.
[CUSTOMER][POSITIVE] Got it. Awesome. You have a lovely day. Thanks for your information. I appreciate it.
[AGENT][POSITIVE] OK, thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye.