AccountId: 011433970860
ContactId: 2b3d70ac-a07a-4019-9adf-903aa1d3e4ca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248229 ms
Total Talk Time (AGENT): 100413 ms
Total Talk Time (CUSTOMER): 43187 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/2b3d70ac-a07a-4019-9adf-903aa1d3e4ca_20250403T12:02_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Good morning. I was calling to get eligibility and benefits, please.
[AGENT][NEUTRAL] OK, and is this service at a doctor's office?
[CUSTOMER][NEUTRAL] I'm sorry, say that again.
[AGENT][NEUTRAL] Is this for service at a doctor's office?
[CUSTOMER][NEUTRAL] Uh, yeah, it's for a doctor's office of physician office visit.
[AGENT][NEUTRAL] OK. Do you have me on speaker?
[CUSTOMER][NEUTRAL] No, I'm on a headset.
[AGENT][NEUTRAL] OK, because you sound far away. uh, what is your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the policy number [PII]?
[CUSTOMER][NEUTRAL] 00964740
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] All right, thank you for that information, uh, [PII], I'm showing an effective date of [PII]. The policy is active at this time, and you said office visit?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, give me 1 2nd.
[AGENT][NEUTRAL] Alright, I have the policy pulled up here. Let's see.
[AGENT][NEUTRAL] All right. So the physician outpatient treatment benefit is up to $25 per visit, a maximum of 4.
[AGENT][NEUTRAL] Visits per calendar day per covered person.
[AGENT][NEUTRAL] And
[AGENT][NEGATIVE] I'm showing a max of 8 visits for calendar year for all covered persons combined and currently I don't show any of the benefits used for [PII].
[AGENT][NEUTRAL] For [PII].
[CUSTOMER][NEUTRAL] OK thank you um do they have a network with their plan?
[AGENT][NEUTRAL] Um, this is a supplemental gap plan, so it's a secondary payer to the major medical plan.
[CUSTOMER][NEUTRAL] OK, may I have the claims address and payer ID if you have one please?
[AGENT][NEUTRAL] American Public Life [PII].
[AGENT][NEUTRAL] And payer ID is 860801 and did you have any other questions, Summer?
[CUSTOMER][NEUTRAL] Just one more, do they have a group number?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] This information can also be located on the identification card, and I'm showing it to be 160416048.
[CUSTOMER][NEUTRAL] And I'm showing it
[CUSTOMER][NEUTRAL] Thank you. I don't have the card. That's why I'm asking. Could I get a call reference number?
[AGENT][NEUTRAL] It'll be my name in today's date, [PII] and any other questions?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] You're welcome thanks for calling APL Center. Have a good day.
[CUSTOMER][POSITIVE] Have a good day. Bye-bye.