AccountId: 011433970860
ContactId: 034adc98-3bbb-4054-8430-4b8c413dd75b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305980 ms
Total Talk Time (AGENT): 94453 ms
Total Talk Time (CUSTOMER): 163830 ms
Interruptions: 7
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/034adc98-3bbb-4054-8430-4b8c413dd75b_20250314T13:36_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII], last initial [PII]. I'm calling to, uh, request a patient's current insurance coverage.
[CUSTOMER][POSITIVE] Exactly.
[AGENT][NEUTRAL] May I please have a callback number?
[CUSTOMER][NEUTRAL] Yes, that's gonna be [PII].
[CUSTOMER][NEUTRAL] Basa that I can.
[AGENT][NEUTRAL] May I have the policy number?
[CUSTOMER][NEUTRAL] Yes, give me one moment.
[CUSTOMER][NEUTRAL] Let me just make sure I give you the one that's on the card because.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's gonna be the payer ID on the card, right?
[AGENT][NEUTRAL] It will be the outpatient benefit certification number.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Oh there it is OK 023296-888.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, 8.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] No that's.
[CUSTOMER][NEUTRAL] Spain.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] And I'm pulling that information up for you.
[CUSTOMER][NEUTRAL] Go.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Sorry, as you're pulling that up, could you please provide the spelling for your name and the last initial?
[AGENT][NEUTRAL] The call reference will be my first name, last initial of [PII] and today's date, and the spelling is [PII]
[CUSTOMER][NEUTRAL] Oh, it's not.
[CUSTOMER][NEUTRAL] And you said [PII] for the last name, right? OK, thank you.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] You're welcome. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, so the last name is gonna be [PII] The first name is gonna be [PII]
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] That's gonna be [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy. You're calling in for benefits. Is that for inpatient, outpatient, or an office setting?
[CUSTOMER][NEUTRAL] I don't know it's different.
[CUSTOMER][NEUTRAL] Outpatient.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] Oh my god, there's a bunch of people that don't wanna be there. Why is it that they keep adding me?
[CUSTOMER][NEUTRAL] It's like I need um.
[CUSTOMER][NEUTRAL] Oh, is that.
[AGENT][NEUTRAL] I apologize for some reason my system is running slow.
[CUSTOMER][NEUTRAL] You're totally fine. Every insurance person I've called today has had the same issue.
[CUSTOMER][POSITIVE] Or maybe if I do some authentic I can go to the garden.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] And this is rendered within an outpatient facility?
[CUSTOMER][NEUTRAL] My [PII], 30 years.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So for this member it looks like they only have.
[AGENT][NEUTRAL] Inpatient benefits.
[CUSTOMER][NEUTRAL] Oh, their card has an outpatient number on it.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Let me, it's still pulling up. I don't wanna give you the wrong information.
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEUTRAL] Here we go. OK, so for outpatient verification of coverage does not guarantee the payment of the claim. The member has up to $3500 per calendar year that will go towards the primary insurance deductible, co-insurance, or co-pay. This policy is for sickness and injury only. It will not cover any preventative or wellness. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Just.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] get
[CUSTOMER][NEUTRAL] Yes, how much of that, uh, benefit has been used?
[AGENT][NEUTRAL] Let me pull that up for you.
[CUSTOMER][NEUTRAL] That is like
[CUSTOMER][NEUTRAL] It's like they're pulling my hair.
[AGENT][NEUTRAL] As of right now, it shows that the member has used the total amount of $2,784.37.
[CUSTOMER][POSITIVE] And he had quite a few times OK perfect.
[CUSTOMER][POSITIVE] Thank you so much for your help, [PII]. Have a great day.
[AGENT][POSITIVE] You're welcome and thank you for calling American Public Life, [PII]. Have a great day as well.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye.