AccountId: 011433970860
ContactId: 2400a538-4bca-4c14-9d98-3e6a338e2b82
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 147160 ms
Total Talk Time (AGENT): 73754 ms
Total Talk Time (CUSTOMER): 35639 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/2400a538-4bca-4c14-9d98-3e6a338e2b82_20250604T14:11_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, I'm calling from Main Street Urgent Care, and I need to verify if a patient's uh eligible and if they have urgent care benefits.
[AGENT][NEUTRAL] May I have your name and a callback number?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] 02618983
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Name is [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] Oh sorry, [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm pulling that information up for you now.
[AGENT][NEUTRAL] And you're calling to see if this member has urgent care benefits?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, I'm pulling that up for you now.
[AGENT][NEUTRAL] And the member does have a different policy number. Are you ready for that?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That is 02.
[AGENT][NEUTRAL] 636-118 and it does show the effective date is [PII].
[AGENT][NEUTRAL] And for out
[CUSTOMER][NEUTRAL] Sorry, what was the effective date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're calling for the urgent care verification of coverage does not guarantee the payment of the claim. The member does have up to $250 per occurrence that will go towards the primary insurance deductible, co-insurance, or co-pay. 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 he does not have a copay, is that correct?
[AGENT][NEUTRAL] We will pay up to $250. If that member does have a co-pay, you will have to check with the primary insurance.
[CUSTOMER][NEUTRAL] So this is not his primary insurance?
[AGENT][NEUTRAL] This is a supplemental or gap.
[CUSTOMER][POSITIVE] OK, OK, thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] You too bye