AccountId: 011433970860
ContactId: 030cce8e-67e5-4e79-ba5d-225ddb9706ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 168699 ms
Total Talk Time (AGENT): 82770 ms
Total Talk Time (CUSTOMER): 69576 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/030cce8e-67e5-4e79-ba5d-225ddb9706ab_20250320T19:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. I'm sorry, good afternoon. I'm calling from a doctor's office to confirm if a patient's plan is currently active and also to confirm, um, we're a specialist office if um this um plan will cover like her deductible and her co-pays in a specialist office.
[AGENT][NEUTRAL] I can verify benefits and eligibility. May I have your name and the policy number?
[CUSTOMER][NEUTRAL] Yes, uh, policy number is 02502639 and uh my name is [PII], initial [PII].
[AGENT][POSITIVE] Thank you. May I have a good callback number for you, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Flo [PII] [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. This policy is effective [PII] and it is active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This is their secondary plan. It will pick up the copays, the co-insurance, and our deductibles up to the benefit amount.
[AGENT][NEUTRAL] So under this plan, the specialist office visit allows $25 for physicians, $50 for a specialist.
[CUSTOMER][NEUTRAL] Oh, OK, love, so then whatever her copay is, we will subtract $50 that will be covered by the APL, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Perfect. And then you told me her deductible too would be covered. Does it have like a limit?
[AGENT][NEUTRAL] Yes, it will pick up the copays, the co-insurance and our deductibles up to 2500.
[CUSTOMER][NEUTRAL] Got it um.
[CUSTOMER][NEUTRAL] Question, would you be able to check for me if she used up any of those benefits for her deductible and her co-pays for a specialist?
[AGENT][NEUTRAL] Sure, one moment. Now, for the actual office visits, she's allowed 4 visits per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So let me see if she's used any.
[AGENT][NEUTRAL] She has used one for [PII], so she still has 3 visits remaining.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then for the deductible of does she still have the full 2500 or has she used anything towards that?
[AGENT][NEUTRAL] Nothing has been applied for outpatient. That's separate from her office visits.
[CUSTOMER][NEUTRAL] Trial patient.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK perfect alright thank you so much for your help.
[AGENT][POSITIVE] [PII], you're so welcome. Is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, that's all thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling American Public Life, [PII]. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] You too bye