AccountId: 011433970860
ContactId: 32ef2d53-1882-4878-ac22-340ca0cb0d51
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 189539 ms
Total Talk Time (AGENT): 96504 ms
Total Talk Time (CUSTOMER): 87818 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/32ef2d53-1882-4878-ac22-340ca0cb0d51_20250609T18:02_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good afternoon. My name is [PII]. I'm calling with University of Virginia Medical Center. We need to verify benefits please for a patient.
[AGENT][NEUTRAL] OK, I can help you with that, [PII]. Could I get a callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] That's 025730777.
[AGENT][NEUTRAL] The patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying the policy. Uh, is this going to be for outpatient facility?
[CUSTOMER][NEUTRAL] It's gonna be for
[CUSTOMER][NEUTRAL] Yes, um, specialist office visit. Um, it's just an initial, yeah, it's just a, um, office visit for an initial visit, and it looks like she's got Aetna as primary. If you could just confirm that's the information you have as well.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, office visit, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, please be advised verifying benefits is not guaranteed payment. Her policy with us has been effective since [PII] and still active.
[AGENT][NEUTRAL] Uh, I do, uh, let's see, BMT, I show that, um.
[AGENT][NEGATIVE] A physician office visit would not be covered.
[AGENT][NEUTRAL] Uh, and I do show, uh, [PII] as her primary.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh no, I'm sorry, it it's the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's not covered. OK, uh, what type of plan is this that it won't cover the office visits?
[AGENT][NEUTRAL] Yeah, this is a supplemental gap policy and I show with uh her policy, it only covers outpatient facility and inpatient facility.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Services in the doctor's office would not be covered.
[CUSTOMER][NEUTRAL] So that's where there's like a fine line because we're we're a hospital we are considered an outpatient facility just because we're, we, the doctor's umbrella UVA, um.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] So if the physician uh bills, uh, you know, and let, until we receive the claim, I can, I can only quote the benefits, uh, as, you know, services rendered in the physician's office are not covered, but depending on, you know, you can submit the claim and just, you know, once it's reviewed.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, well
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, we'll do that. We'll do that, um, uh, and then there's no referral required because it's a supplemental gap, right? OK, um, do you have a reference number for this call?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No. No, ma'am. Referrals are not required.
[AGENT][NEUTRAL] Yes, ma'am. To reference our call, you will use my name, [PII] and today's date.
[CUSTOMER][POSITIVE] OK, alright, I appreciate it thank you.
[AGENT][POSITIVE] You're welcome, [PII]. You have a wonderful day. Thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you you as well. OK, bye bye.
[AGENT][NEUTRAL] Bye bye.