AccountId: 011433970860
ContactId: 2191a6e6-6bd4-4231-aa3b-49ba77d6af02
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 231429 ms
Total Talk Time (AGENT): 121959 ms
Total Talk Time (CUSTOMER): 60462 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/2191a6e6-6bd4-4231-aa3b-49ba77d6af02_20250122T13:39_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, good morning. My name is [PII]. I'm calling regarding benefits for a patient.
[AGENT][NEUTRAL] OK, and you said your name is [PII]?
[CUSTOMER][NEUTRAL] Yes, that is [PII]
[AGENT][NEUTRAL] OK, thank you, [PII]. And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it is 01611530 ML 8.
[AGENT][NEUTRAL] OK. Give me one minute, let me get this information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You said that's 161153 I'm sorry, 538.
[CUSTOMER][NEUTRAL] No, it is 01, uh let me repeat it. 01611530. M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] OK. Oh, thank you. Uh, you know, what is the, the patient's name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. And you're wanting to verify coverage?
[CUSTOMER][NEUTRAL] Yes, for specialist office visit.
[AGENT][NEUTRAL] OK, this patient, um, well, give me one minute and let me review this policy.
[AGENT][NEUTRAL] This is a medical supplemental policy. It's not like a major medical. This call is not um approval and benefits.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEGATIVE] It's not a guarantee.
[AGENT][NEUTRAL] And there's no pre-approved required benefits are paid, what's in the listed in the policy. Uh, the effective date of the coverage is [PII].
[AGENT][POSITIVE] The coverage is active.
[AGENT][NEUTRAL] Give me just a few more minutes while I pull up this, this, and this is for an office visit, correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, for specialist office visit.
[AGENT][NEUTRAL] In a physician's office, OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, it does have a benefit for office treatment benefit that would for treatment, it doesn't cover the physician's fees.
[AGENT][NEGATIVE] The office physician fees. It does not cover that. It only covers the treatment in the office.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It picks up the co-pay, deductible and co-insurance of approved services of the Medicare or the major medical insurance company.
[CUSTOMER][NEUTRAL] OK. Uh, does it, uh, I mean, uh, previously was sold, uh, uh, the coverage is up to $1500 per year.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's a maximum of $1500 per person per calendar year for covered outpatient services.
[CUSTOMER][NEUTRAL] OK. And has the patient used any of it?
[AGENT][NEUTRAL] Um, give me one minute, let me check on that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No, the patient has not used anything for the calendar year of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][POSITIVE] My pleasure. Is there anything else I can help you out with, Ms. [PII]?
[CUSTOMER][NEUTRAL] Nothing else right now. That is all for now.
[AGENT][POSITIVE] OK. OK. Well, you have a wonderful day and thank you for calling American Public Life.
[CUSTOMER][POSITIVE] Thank you. Have a good day. Bye-bye.
[AGENT][NEUTRAL] Oh, I mean, get by Miss [PII].
[CUSTOMER][NEUTRAL] Bye.