AccountId: 011433970860
ContactId: 1055315a-7e32-4e51-a2b9-ec003a9512ba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 356220 ms
Total Talk Time (AGENT): 155351 ms
Total Talk Time (CUSTOMER): 87283 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/1055315a-7e32-4e51-a2b9-ec003a9512ba_20250108T19:24_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling with Village Medical. I have a patient coming in that has this insurance, and I was calling just to see if I can get um eligibility and benefits for it.
[AGENT][NEUTRAL] OK, [PII], you're needing to get eligibility and benefits for a member, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes, ma'am. I can help you with those things. And what is your callback number, please?
[CUSTOMER][NEUTRAL] Area code [PII].
[AGENT][NEUTRAL] Thank you, one moment. And what is the policy number for the member, please?
[CUSTOMER][NEUTRAL] I have D as in dog 43302175.
[AGENT][NEUTRAL] OK, so that is not an APL policy number. Were you trying to reach 90 degree benefits or does this number also have a policy with APL as well?
[CUSTOMER][NEUTRAL] Um, you know what? I don't know. She gave me, um, well it says American Public Life, but then she gave me another number as well, uh 02514582.
[AGENT][NEUTRAL] OK, that would be the policy number for American Public Life, the 2nd number that you gave me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK just one moment please
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. So she is the subscriber on this hospital indemnity limited benefit plan.
[AGENT][NEUTRAL] This policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And what type of benefit information are you needing for her inpatient, outpatient or office?
[CUSTOMER][NEUTRAL] Office.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK. And is this for related to an illness?
[CUSTOMER][NEUTRAL] Um, she just said she's coming in to see her primary care provider.
[AGENT][NEUTRAL] OK. She has an outpatient sickness benefit on this policy where the benefit amount is $75 per visit.
[AGENT][NEUTRAL] With a maximum of 5 visits per calendar year.
[CUSTOMER][NEUTRAL] And when you stayed outpatient, that's same as doctor's office?
[AGENT][NEUTRAL] That would be for a physician's office and, excuse me, a physician's office that is the benefit amount on this plan with a max of 5 visits uh per calendar year.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and is there a group number on this policy?
[AGENT][NEUTRAL] Yes, ma'am. One moment.
[CUSTOMER][POSITIVE] Easy to go back.
[AGENT][NEUTRAL] Uh, the group number is 70052.
[CUSTOMER][NEUTRAL] OK, and then would we be billing it out to the [PII]?
[AGENT][NEUTRAL] In [PII]. Mhm. Yes, ma'am, that is correct.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And then once the claim, oh, I'm so sorry. I know, you go ahead first.
[CUSTOMER][NEUTRAL] Alright, and then go ahead sorry.
[CUSTOMER][NEUTRAL] I was just gonna ask, is there a termination date?
[AGENT][NEUTRAL] There is not policy is active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And once the claim has been processed, we do have a portal trainer which claim status can be checked and the EOBs be printed from, and that website for our portal is secured. Let me try that one again. I messed that all up, secured. Ampublic.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] No, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] AM
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Yes, ma'am.
[CUSTOMER][POSITIVE] All right, well thank you so much for your time. Is there a reference number?
[AGENT][NEUTRAL] Yes, ma'am, you would actually just use my name along with today's date.
[CUSTOMER][NEUTRAL] OK, and could you spell that name for me?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] All right thank you so much have a great rest of your day.
[AGENT][POSITIVE] Well, you're, yes, ma'am. You too and thank you again, [PII] for calling APL.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] That