AccountId: 011433970860
ContactId: 12e52fa8-e4f9-4810-be48-de0552d904bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 312559 ms
Total Talk Time (AGENT): 116800 ms
Total Talk Time (CUSTOMER): 90160 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/12e52fa8-e4f9-4810-be48-de0552d904bf_20250609T19:22_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] Um, hi. Uh, good afternoon, [PII]. Um, I would just like to get benefit information for two of our patients.
[AGENT][NEUTRAL] I can verify benefits. May I have your name and a policy number?
[CUSTOMER][NEUTRAL] My name is [PII], my initial, calling from a provider's office.
[CUSTOMER][NEUTRAL] Uh, member's ID number is 01887.
[CUSTOMER][NEUTRAL] [PII] Mama [PII].
[AGENT][POSITIVE] Thank you. May I have a good callback number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. May I have a date of service?
[CUSTOMER][NEUTRAL] Uh, tomorrow.
[AGENT][NEUTRAL] So you just wanna verify the benefits. I do apologize for that. Let me get that. Please be advised the verification of coverage does not guarantee the payment of a claim. And which benefit can I provide for you?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Specialist office visit?
[AGENT][NEUTRAL] OK, so let's see.
[AGENT][NEUTRAL] They do have the office treatment, but not the actual office visit benefit. So any treatment received in the office is covered under the outpatient calendar year benefit amount of $1000. The actual office visit itself is not covered.
[CUSTOMER][NEUTRAL] How much is the outpatient benefit maximum?
[AGENT][NEUTRAL] The maximum is $1000.
[CUSTOMER][NEUTRAL] 10 is, uh, what's the accommodation?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] $50 has been applied for 2025.
[CUSTOMER][NEGATIVE] I'm having a hard time hearing you.
[AGENT][NEUTRAL] $50 has been applied for 2025.
[CUSTOMER][NEUTRAL] 50, so remaining is 950.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Thank you. Can I have a reference number?
[AGENT][NEUTRAL] Yes, it will be my name, which is [PII] Last initial is [PII] along with today's date.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] I have another patient.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] One moment as well. Let me just close this patient.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] For the next one, are you ready for the member ID?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Uh, it's going to be 02610391.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you for verifying that information.
[AGENT][NEUTRAL] And which benefit can I provide?
[CUSTOMER][NEUTRAL] Sa specialist office visit.
[AGENT][NEUTRAL] OK, so under this plan, there is no office visit benefits?
[AGENT][NEUTRAL] This one does have the office treatment as well, which falls under the outpatient benefit of $5000.
[AGENT][NEUTRAL] Just waiting on the system to see if there's any accumulations.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And no benefits have been applied for 2025.
[CUSTOMER][NEUTRAL] We still have the full 5000.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Oh, I heard it right, $5000.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] Oh, OK, that's all for today. Thank you so much.
[AGENT][POSITIVE] [PII], you're so welcome and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] OK. Bye-bye.