AccountId: 011433970860
ContactId: 44b6db2f-46f1-4aff-85fd-0995c5dcfbad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 193720 ms
Total Talk Time (AGENT): 69036 ms
Total Talk Time (CUSTOMER): 73290 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/44b6db2f-46f1-4aff-85fd-0995c5dcfbad_20250305T19:46_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] Yes, hi, good afternoon, [PII]. My name is [PII]. I'm calling from our provider's office and I'm calling to find out if you guys cover the um member copay.
[AGENT][NEUTRAL] May I please have a callback number and then the policy number?
[CUSTOMER][NEUTRAL] It is [PII] policy number it is 2, I'm sorry, [PII].
[AGENT][NEUTRAL] The [PII]?
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII], [PII].
[AGENT][NEUTRAL] And you're calling in for benefits, is this for office and inpatient or outpatient?
[CUSTOMER][NEUTRAL] For office, outpatient.
[AGENT][NEUTRAL] This is done within an office setting, correct?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm pulling that information up for you now.
[CUSTOMER][NEUTRAL] Mhm. And what's the correct spelling of your first name?
[AGENT][NEUTRAL] It is spelled [PII] Last initial of [PII] and today's state will be the call reference.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And verification of coverage does not guarantee the payment of the claim for this policy. They don't have the office visit fee benefit rider, but they do have the office treatment benefit rider which covers up to $3000 per calendar year for the procedure rendered within an office setting.
[CUSTOMER][NEUTRAL] OK. When you say procedure, like, for instance, um, an X-ray or ultrasound, but just to see a PCP, is that covered cause there's no procedure, it's just an office visit.
[AGENT][NEUTRAL] If they're being billed for the office visit, this policy does not cover the office visit fee.
[CUSTOMER][NEUTRAL] OK. That's what I, OK, that's what I just needed clarification on, but it does cover for procedures done in, in office. OK.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And you said the reference number is your first name and your last initial again, I'm sorry?
[AGENT][NEUTRAL] Last initial of H.
[CUSTOMER][POSITIVE] OK. All [PII]. Thank you.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life, Juliet, have a great day.
[CUSTOMER][NEUTRAL] You too.