AccountId: 011433970860
ContactId: 3affdea8-9b99-4f3d-b876-f031d746669c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 445309 ms
Total Talk Time (AGENT): 179184 ms
Total Talk Time (CUSTOMER): 185341 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/3affdea8-9b99-4f3d-b876-f031d746669c_20250620T17:11_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 [PII], is there any way that you could look up my policy for me?
[AGENT][NEUTRAL] May I have your name?
[CUSTOMER][NEUTRAL] It's [PII] and my last name is [PII].
[AGENT][NEUTRAL] And do you have your policy number?
[CUSTOMER][NEUTRAL] I actually, I don't, um.
[CUSTOMER][NEUTRAL] And everybody in my office is out right now.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Is there any way to, because I actually, I never even got a card.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Or any sort of anything. I can tell you um the effective date. I have a checkmark that I'm covered. I know that it's 6500 to 750.
[CUSTOMER][NEUTRAL] Um, is there any way for you to look it up for me without that? Because I don't have that. That's what I'm needing.
[CUSTOMER][NEUTRAL] A part of what I'm needing anyway.
[AGENT][NEUTRAL] May I have your date of birth, please?
[CUSTOMER][NEUTRAL] It's 1025 79.
[AGENT][NEUTRAL] And may I have a callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And I do need to verify the mailing address that is listed on file.
[CUSTOMER][NEUTRAL] Um, my home address is going to be um [PII].
[AGENT][NEGATIVE] And that was [PII].
[CUSTOMER][NEUTRAL] No. [PII], one word and then the second word is [PII]
[AGENT][NEUTRAL] And what was your apartment number again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna have to get that updated in the system.
[AGENT][NEUTRAL] And that is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] [PII]. OK, I will get that updated as well and could you verify the email address that is listed? Well, we don't even have 1 May I have an email address to enter on file?
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Sure. Um, it could be my first and last name, [PII].
[CUSTOMER][NEUTRAL] L C S W
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's first and last name [PII]?
[CUSTOMER][POSITIVE] Correct. Mhm.
[AGENT][NEUTRAL] OK, I will get that information updated in the system for you as well and you were calling to see if you can get the policy number?
[CUSTOMER][NEUTRAL] So I, I, I need some sort of like, I'm not sure if you can email me or how I can get a card cause I've never, I never received a card. Um, and then I have a question about, um, about my policy as well. And if you, and if you can't send me anything or email me, then the card like the number is fine. I'll take that.
[AGENT][NEUTRAL] OK. And what information are you needing for me to verify for you?
[CUSTOMER][NEUTRAL] So I, I have an upcoming appointment um for a second mammogram. The first one came out that there, there's like an area of concerns or question mark. So they're gonna do a second one and I received um information that it's gonna be after the insurance coverage is like 300, almost like 350, and I'm wondering if this is where the gap insurance comes in.
[CUSTOMER][NEUTRAL] Or if this is maybe more of like an FSA, so I just, I've never used this before so I'm not sure if this is what it is for.
[AGENT][NEUTRAL] OK, I can go ahead and verify the outpatient benefits for you and if you would like, you can contact that provider and you would give them this policy number and the contact information and they may be able to call and give us more details in regards to, to see if this, if that is covered under the policy, but I can go ahead and give you that information if you would like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Sure, I'll take all of it whatever you can give me.
[AGENT][NEUTRAL] OK, so in regards to your policy for outpatient benefits, verification coverage does not guarantee the payment of the claim. You do have up to $750 per calendar day, and that will go towards your primary insurance deductible, co-insurance, or co-pay.
[AGENT][NEUTRAL] This policy does only cover sickness and injury. It will not cover any type of preventative or wellness.
[AGENT][NEUTRAL] And in regards to your policy number, are you ready for that?
[CUSTOMER][NEUTRAL] I am.
[AGENT][NEUTRAL] It is 02.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and it does show that the effective date is [PII] and currently active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I can get the request, go ahead.
[CUSTOMER][NEUTRAL] So it sounds to me like
[CUSTOMER][NEUTRAL] Go ahead, you can do what, please?
[AGENT][NEUTRAL] I was gonna get the request for them to submit you a card either via mail and then you can also go on to our secured portal and set up that secure portal and you will be able to download download that card as well.
[CUSTOMER][NEUTRAL] OK, and I, I have the website pulled up right now so I can, I'll go in and I'll um create an account there.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, but it sounds like because this would be a 2, like a 2nd screening that to me sounds preventative, so that doesn't sound like this is what the policy is for.
[AGENT][NEUTRAL] It would be based off of how the provider submits that claim in, so that's probably why it's best to give the provider the information and they will be able to give us more details on what the services is for, and they will be able to decide if it is considered a covered benefit or not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um is that something that is done pretty quickly?
[CUSTOMER][NEUTRAL] Or decided pretty quickly how does like what's the turnaround time for that?
[AGENT][NEUTRAL] Once, once they call and just let us know and we will be able to let them know that it, if it's preventative or wellness or sickness or injury, the provider will actually know if it is preventative or wellness.
[CUSTOMER][POSITIVE] OK, sounds good. All right, well thank you for your time.
[AGENT][POSITIVE] You're welcome. And is there anything else that I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] No, that's it. Thank you so much.
[AGENT][POSITIVE] Thank you for calling American Public Life. Have a great day.
[CUSTOMER][POSITIVE] Have a nice day.