AccountId: 011433970860
ContactId: 35248893-e0f2-4b5b-b4c8-684c879765ba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 227970 ms
Total Talk Time (AGENT): 79778 ms
Total Talk Time (CUSTOMER): 94981 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/35248893-e0f2-4b5b-b4c8-684c879765ba_20250408T17:42_UTC.wav
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[AGENT][NEUTRAL] For calling American Public Life, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, hi, uh, I am calling from provider's office. Uh, do you need the NPI to begin with?
[AGENT][NEUTRAL] No, I, I need your name and a callback number.
[CUSTOMER][NEUTRAL] Sure. My name will be [PII], uh which will be [PII] and the callback number will be [PII].
[AGENT][POSITIVE] OK, thank you for that, [PII]. Uh, how can I help you today?
[CUSTOMER][NEUTRAL] So, uh, two things we we have a member, uh, I can give you the member ID, uh, hold on, the member ID is 02481622.
[CUSTOMER][NEUTRAL] The patient's last name, sorry.
[AGENT][NEUTRAL] Patience
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] The patient's last name is [PII] and the first name will be [PII].
[AGENT][NEUTRAL] OK, if you could verify the date of birth please.
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][POSITIVE] OK, thank you so much for verifying the policy and how can I help you today?
[CUSTOMER][NEUTRAL] So we wanted to know, uh, are we in network for this plan, and secondly, will the wellness visit be covered by this plan?
[AGENT][NEUTRAL] Well, the, OK. So this is a um limited medical plan. There is no contract. Uh, the uh the the insurer can go to any provider. And what type of service are you asking as far as coverage?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, for the wellness visit, will it be covered if you do that annual checkup?
[AGENT][NEUTRAL] I'm sorry. Oh, the annual checkup. OK, let me see. Please be advised verifying benefits is not guarantee payment. Uh let me check and see if this policy has uh a routine.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it appears uh routine health screening is covered.
[AGENT][NEUTRAL] Uh, the policy will pay $50 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, mhm, OK, so I have a procedure code 99395. How much will the insurance, uh, pay to the provider for this for this core of service?
[AGENT][NEUTRAL] That benefit is the $50 it pays $50.
[CUSTOMER][NEUTRAL] $50.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and are we in network for this plan?
[AGENT][NEUTRAL] There is no network. This is a non-contracted policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got it. Um, thank you, thank you then. Thanks a lot. And can I get a reference ID for this call?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, to reference the call, you'll use my name, [PII] and today's date.
[CUSTOMER][POSITIVE] OK, thank you [PII], thanks for your help.
[AGENT][POSITIVE] You're welcome. You have a wonderful day. Thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] You too.