AccountId: 011433970860
ContactId: f88c4ff3-c5ca-4d74-ac32-4dd4821ea502
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 318559 ms
Total Talk Time (AGENT): 136178 ms
Total Talk Time (CUSTOMER): 156709 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/f88c4ff3-c5ca-4d74-ac32-4dd4821ea502_20250218T19:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEGATIVE] Yes, uh, hello, my name is. I'm just calling by one day and they got the office and I needed to know what are my benefits in there, but I'm supposed to pay my copayments and, uh, you know, pay the $10.
[CUSTOMER][NEGATIVE] With I supposed to pay or I pay the $10. I don't know, sure, no, I need to know. I need to pay that uh $10 or you, you just pay that $50 for the special.
[AGENT][NEUTRAL] OK, um,
[AGENT][POSITIVE] I can help you with your benefits. Can you please give me your name again, please?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] and my first name and last name is [PII]
[AGENT][NEUTRAL] OK, thank you. And then what is your callback number just in case our call is disconnected?
[CUSTOMER][POSITIVE] Yeah, it's really fun.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and.
[CUSTOMER][NEUTRAL] I'm sorry, I.
[AGENT][NEUTRAL] That's OK. And what is
[CUSTOMER][NEUTRAL] I'm in the office.
[AGENT][NEUTRAL] Yes, what is your date, your, um, policy number?
[CUSTOMER][NEUTRAL] OK. My policy number, I think is uh 02502639. That's the policy I have here in the paper. I, uh, I don't not sure. You want me to give you my, my date of birth?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, I will verify that. Um, [PII], what is your date of birth?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and what is your address?
[AGENT][NEUTRAL] Phone number and email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, it's [PII] and my email is my name is [PII] and my phone number is [PII].
[AGENT][NEUTRAL] OK, thank you. I appreciate you verifying that. So you're in the doctor's office now and you're wondering if you should pay the $10 co-pay. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, yeah, that's correct.
[AGENT][NEUTRAL] OK, so what you'll need to do is um.
[AGENT][NEUTRAL] Pay it because it has to be billed on your primary insurance.
[AGENT][NEUTRAL] For
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Pay on the secondary insurance based on what the primary pays. So if the primary is asking for you to pay the $10 then I would pay it and then.
[AGENT][NEUTRAL] When the claim is filed.
[AGENT][NEUTRAL] Uh, it'll, it'll, it'll happen from the explanation of benefits from the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, but I have the explanation benefits for, uh, here I have the papers and, uh, I don't know that the total benefits pay the dollars.
[CUSTOMER][NEUTRAL] And uh I think the reason my car and I'm supposed to open here right now it's $20 for my last two visits and for today's $10 more it's $30.
[AGENT][NEUTRAL] OK, yes, um, when, when you go in.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You give them your primary insurance card and you also give them your secondary insurance card, the insurance card with our company. Give them both, let them know that that insurance helps with deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, that's
[CUSTOMER][NEUTRAL] Yeah, that's, that's that I explained to the lady on the phone and she just, she told me that uh you pay only the benefits by the, my primary insurance is not paid. And say, no, no, no, that is my co-payment, that's not my, that's my secondary, that's not my primary.
[AGENT][POSITIVE] Right, we're secondary, you're right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah. Yes.
[AGENT][NEUTRAL] And then it's based on what the it.
[AGENT][NEUTRAL] This policy pays based on what the primary insurance pays so when the claim is filed, we'll need the explanation of benefits from the primary insurance with the claim to show what they've paid.
[CUSTOMER][NEUTRAL] Oh OK, OK, and you say the lady is uh sending to my primary and my primary is deny, you pay, right?
[AGENT][NEUTRAL] No, if the primary denies, if the primary denies, then we deny because, because it's only based on deductible, co-pay or co-insurance. So if the primary doesn't pay, then we don't pay, we pay what the primary pays.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Don't tell me
[CUSTOMER][POSITIVE] Ah, OK, OK, and right now I pay that, that $30 but I don't want it, you know, that next time pay 40 more or pay more. OK, I want to pay right now and thank you so much. I appreciate it.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] You're very welcome. You have a, a good appointment, Ms. [PII] and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] Thank you bye bye bye bye.
[AGENT][NEUTRAL] Bye bye.