AccountId: 011433970860
ContactId: 1f1f9314-b670-4c02-8487-16df95532041
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 186529 ms
Total Talk Time (AGENT): 83099 ms
Total Talk Time (CUSTOMER): 92174 ms
Interruptions: 1
Overall Sentiment: AGENT=2.1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/1f1f9314-b670-4c02-8487-16df95532041_20250204T16:49_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] Hi [PII], my name's [PII]. I'm calling from a provider's office looking to verify eligibility and benefits for a patient.
[AGENT][NEUTRAL] OK, I can help you with that, [PII]. Could I get a callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, the policy number you're calling on?
[CUSTOMER][NEUTRAL] 022 04155
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying the policy and you did say you were calling for benefits and eligibility. What type of service is the patient coming in for?
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah, we generally be, uh, I can't talk today we generally verify for primary care and specialty office visits, outpatient.
[AGENT][NEUTRAL] OK, OK. Please be advised verifying benefits is not guaranteed payment. I show the policy has been effective since [PII]. It is still active. For a physician visit, the policy pays $75 a visit. The patient has 5 visits a year to use.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, and is that based like beginning of January to end of December, or does it have a different, uh, date based on effective?
[AGENT][NEUTRAL] It is January to December and I show, let me make sure if anything's been used.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I show, uh, they have used one of their visits.
[CUSTOMER][NEUTRAL] OK, wonderful. And then um what is the uh is ASL or sorry, APL the actual name of the insurance?
[AGENT][NEUTRAL] Yes, it is American Public Life.
[CUSTOMER][NEUTRAL] OK, public life, yeah, that's what I thought. And then, um, does that go through any type of network or not really?
[AGENT][NEUTRAL] No, this is a limited medical plan, um, and there there is no network for the policy.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK, so I assume no authorization required for those office visits?
[AGENT][NEUTRAL] P
[AGENT][POSITIVE] Correct, pre-op is not required.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Wonderful and um we have the claims mailing address as going to IMA at [PII]. Is that correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, and then we have a group number listed of 70,030, is that correct?
[AGENT][POSITIVE] That is correct, yes ma'am.
[CUSTOMER][MIXED] Awesome I think that is everything except you give a reference number for the call.
[AGENT][NEUTRAL] To reference the call you will use my name and today's date.
[CUSTOMER][POSITIVE] Perfect, thank you for your time today. I truly appreciate it.
[AGENT][POSITIVE] You're welcome. You have a wonderful day. Thank you for calling American Public Life, [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] Thanks bye.