AccountId: 011433970860
ContactId: 2165d290-3cac-4468-8e7f-79f7983491f9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 148139 ms
Total Talk Time (AGENT): 71940 ms
Total Talk Time (CUSTOMER): 57637 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/2165d290-3cac-4468-8e7f-79f7983491f9_20250113T17:10_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, uh, my name is [PII]. I'm calling from a facility. I was just trying to get benefits on a, um, patients, uh, plan.
[AGENT][NEUTRAL] OK, may I have a callback number please?
[CUSTOMER][NEUTRAL] Uh yes, that'll be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] Uh yes, the number I have is 025.
[CUSTOMER][NEUTRAL] 485-54
[AGENT][NEUTRAL] That's 025485554. May I please have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um [PII], um, date of birth is [PII].
[AGENT][NEUTRAL] And you're calling in for benefits. Is there a specific benefit that you're calling in for?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, well, she's getting the surgery, so I guess I'm just trying to see like if she have a deductible out of pocket and what would her outpatient surgery, um.
[CUSTOMER][NEUTRAL] Co-pay or co-insurance will be.
[AGENT][NEUTRAL] OK, now we are her supplemental to her primary insurance, so we're based off of their primary insurance deductible co-insurance or co-pay, but I can go ahead and give you the benefits with us, and verification of coverage does not guarantee the payment of the claim for outpatient, the member has up to $1500 per calendar year. As I stated, it will go towards the primary deductible co-insurance or co-pay.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[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] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So the, so that $1000 is that like the deductible or the out of pocket?
[AGENT][NEUTRAL] OK, as I stated, we pay the primary insurance deductible, co-insurance, or co-pay, so you would have to contact her primary insurance to see if she has an out of pocket.
[CUSTOMER][NEUTRAL] OK, so this is just a supplemental plan, OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] All right. Thank you so much.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public.