AccountId: 011433970860
ContactId: 20d9ecce-6e18-4190-bca3-9d5305ef8d65
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206600 ms
Total Talk Time (AGENT): 86009 ms
Total Talk Time (CUSTOMER): 81741 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/20d9ecce-6e18-4190-bca3-9d5305ef8d65_20250314T14:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], uh, could you spell your name, please?
[AGENT][NEUTRAL] It is spelled [PII] last initial of [PII] and today's date will be the call reference.
[CUSTOMER][NEUTRAL] OK, perfect. Thank you. Um, um, I need to verify benefits for a patient, please.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, I'm gonna need your name, callback number, and then the policy number.
[CUSTOMER][NEUTRAL] OK, [PII], the first letter and the policy number is
[CUSTOMER][NEUTRAL] 02473478.
[CUSTOMER][NEUTRAL] And the name is [PII]. I'm sorry, [PII], yeah, [PII].
[AGENT][NEUTRAL] May I have the callback number?
[CUSTOMER][NEUTRAL] Oh, call back number [PII].
[AGENT][NEUTRAL] OK, could you repeat that please?
[CUSTOMER][NEUTRAL] 2, I'm sorry, I'm sorry [PII]. I'm so sorry.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII]. Mhm.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And you're calling in for benefits for this member, is this for inpatient, outpatient or an office setting?
[CUSTOMER][NEUTRAL] Yes, outpatient, uh, we, we have, we bill as an office, but it's an outpatient.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] A facility.
[AGENT][NEUTRAL] Is it done within an
[AGENT][NEUTRAL] Office setting
[AGENT][NEUTRAL] Or an outpatient facility.
[CUSTOMER][NEUTRAL] Outpatient facility. Yes, outpatient. Mhm.
[AGENT][NEUTRAL] OK, but you say that you're gonna bill as an office.
[CUSTOMER][NEUTRAL] We usually, yeah, we as an office specialist 11, but we are a freestanding facility outpatient. We don't charge for doctor visits. It's just for the MRI.
[AGENT][NEUTRAL] OK, and what is the facility name?
[CUSTOMER][NEUTRAL] South Florida Diagnostic imaging or partners in radiology?
[AGENT][NEUTRAL] Thank you. And in regards to the member's benefits for outpatient verification of coverage does not guarantee the payment of the claim. The member does have up to $1500 per calendar day that will go towards the primary insurance deductible, co-insurance, or copay.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 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] So don't cover uh wellness.
[AGENT][NEUTRAL] It does not cover preventive or wellness.
[CUSTOMER][NEUTRAL] But it would cover
[CUSTOMER][NEUTRAL] Oh, she's coming to do an MRI.
[AGENT][NEUTRAL] If it's for sickness or injury, it's considered up under the outpatient.
[CUSTOMER][NEUTRAL] I'm not sure if
[AGENT][NEUTRAL] Benefits.
[CUSTOMER][NEUTRAL] So it's covered it's um uh sickness.
[AGENT][NEUTRAL] If it's for sickness or injury, it is considered up under the outpatient benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, perfect. All right, thank you. Um, you gave me the reference. What's the effective date?
[AGENT][NEUTRAL] It's showing the effective date as [PII].
[CUSTOMER][POSITIVE] Alright thank you I appreciate your help.
[AGENT][POSITIVE] You're welcome thank you for