AccountId: 011433970860
ContactId: 00cbb1a2-f0e4-40c8-9e83-62eb75f0e334
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 371609 ms
Total Talk Time (AGENT): 117251 ms
Total Talk Time (CUSTOMER): 127625 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/00cbb1a2-f0e4-40c8-9e83-62eb75f0e334_20250217T17:30_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, good morning, [PII]. This is [PII] from Florida Women's Care. I'm calling about a pay whether we're in network with this patient's plan and um.
[CUSTOMER][POSITIVE] Thank you. If, if, if we're done and if I'm so sorry.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] I'm calling to see if we're in network with this patient's plan and then if we are in network um um could we have her benefits and if we're out of network could we have any out of network benefits? I'm so sorry.
[AGENT][NEUTRAL] OK, no problem. Can I get your name again?
[CUSTOMER][NEUTRAL] [PII] My last initials [PII].
[AGENT][NEUTRAL] And [PII], could I get a callback number, please?
[CUSTOMER][NEUTRAL] Yes, it'll be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Patients, uh, policy number, please?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Policy number is 2002 I'm so sorry, 02.
[CUSTOMER][NEUTRAL] 509-863
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] and her last name is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you so much for verifying her account. You're calling for benefits, uh, and what type of service is the patient coming in for?
[CUSTOMER][NEUTRAL] She's coming in for office visits.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um a diagnostic ultrasound.
[AGENT][NEUTRAL] OK, please be advised verifying benefits does not guarantee payment. So this is a supplemental gap policy that does pay secondary to her major medical. There is no um.
[AGENT][NEUTRAL] Um, contract we do follow the primary.
[AGENT][NEUTRAL] Um, and so for a physician visit, let me check that.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so the physician office visit would not be covered. OK, uh, the physician office visit for the ultrasound in the physician office that will pay up to $1000 a day.
[CUSTOMER][NEGATIVE] For specialists, I would not be covered. Thank you.
[CUSTOMER][POSITIVE] Thank you and give me one moment.
[CUSTOMER][NEUTRAL] Even if it's billed without the office visit, will the diagnostic ultrasounds be covered still?
[AGENT][NEUTRAL] If any patient responsibility is applied to the ultrasound, it is paid up to $1000 a day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's $1000 thank you.
[CUSTOMER][NEUTRAL] Give me one moment covered.
[CUSTOMER][NEUTRAL] And there's no authorization or referrals required for this one for this plan, right?
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] That is correct, yes ma'am.
[CUSTOMER][NEUTRAL] And her primary insurance is listed with this policy is her United Healthcare correct.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] The primary insurance listed with this policy is her United Healthcare, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you and.
[CUSTOMER][NEUTRAL] Can I have her group number?
[AGENT][NEUTRAL] Uh, let me get that for you.
[AGENT][NEUTRAL] Her group number is 26542.
[CUSTOMER][NEUTRAL] Thank you and can I have her um claims mailing address for this policy?
[AGENT][NEUTRAL] Uh, mailing address for claims will be [PII].
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And the date that this policy started?
[AGENT][NEUTRAL] Let's see, I show the policy effective [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] And she doesn't um no this is a gap so it doesn't have any like responsibility. There's no there's no like deductible respo or um out of pocket that is with this policy, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And can I have the spelling of your name and then a reference number for this call?
[AGENT][NEUTRAL] The reference uh number will be to reference the call you'll use my name in today's date spelled [PII]
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Can I, um, could you repeat your the spelling to make sure that I have the correct spelling? I'm so sorry.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Thank you so much and have a great day.
[AGENT][POSITIVE] You too. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] That's all have a great day.
[AGENT][POSITIVE] OK, you have a wonderful day thank you for calling APO bye bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.