AccountId: 011433970860
ContactId: 47e8e8bf-8aa3-47f0-b05a-3bc018ac0220
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 417339 ms
Total Talk Time (AGENT): 167917 ms
Total Talk Time (CUSTOMER): 118155 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/47e8e8bf-8aa3-47f0-b05a-3bc018ac0220_20250624T16:49_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, I need to find out what benefits I have through you.
[AGENT][NEUTRAL] OK, may I have your name please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], may I please have a callback number and then the policy number?
[CUSTOMER][NEUTRAL] The callback number is [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I don't have a policy number. I've got, well, let me see, hang on, let me make sure of that.
[CUSTOMER][NEUTRAL] No, it just says American public life gap in hand.
[AGENT][NEUTRAL] Does it not have a benefit certification number listed outpatient or inpatient?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] It doesn't, I, I don't have a.
[CUSTOMER][NEUTRAL] A policy for uh in my hands it's through my employer.
[AGENT][NEUTRAL] May I have your social please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] And could you please verify your date of birth with me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And I do need to verify the mailing address that is listed on file and also enter a personal email address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And my personal email address is [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying your policy and I will get your email address updated as well and you were calling in to see what benefits that you have with us?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, is there a specific benefit that you're needing for me to review?
[CUSTOMER][NEGATIVE] Yes, so I fell and broke my wrist.
[CUSTOMER][NEUTRAL] I've been out of work for a couple of weeks.
[CUSTOMER][NEUTRAL] I've accrued some medical bills.
[CUSTOMER][NEUTRAL] So I don't know whether or not I have any hospital indemnity through you or medical gap that will help me with my deductibles.
[AGENT][NEUTRAL] Let me check that for you and is this for inpatient, outpatient?
[AGENT][NEUTRAL] Or an office setting.
[CUSTOMER][NEUTRAL] It was out it was outpatient. I had surgery.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I'm pulling your outpatient benefits up for you now.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And verification of coverage does not guarantee the payment of the claim. For outpatient, you do have up to $250 per occurrence in which that will go towards your primary insurance deductible, co-insurance, or co-pay. This policy is for sickness and injury. It does not cover any type of preventative or wellness, so you do have a full $250 per occurrence.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, so that would just be the one time $250 correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, how do I file for that?
[AGENT][NEUTRAL] You do have the option to either submit the primary EOB showing your responsibility, which is the deductible co-insurance or co-pay. We will have to have an itemized bill from that provider.
[AGENT][NEUTRAL] And if it was, like you stated, an outpatient surgery, you would have the discharge papers in which that will show the reason of that visit or indicate the diagnosis code on there. So that will have to be submitted in to us for us to review.
[CUSTOMER][NEUTRAL] How do I submit that?
[AGENT][NEUTRAL] You have the option to submit it either via the secured portal, fax or mail.
[CUSTOMER][NEUTRAL] Alright, and how do I get into your portal?
[AGENT][NEUTRAL] The secured portal is.
[CUSTOMER][NEUTRAL] What is my
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I was gonna ask you what my account what my insurance policy number was.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And for the, your policy that is 02.
[AGENT][NEUTRAL] 55.
[AGENT][NEUTRAL] 0292.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And for the secured portal, that is secured, spelled SEC.
[CUSTOMER][NEUTRAL] In your portal.
[AGENT][NEUTRAL] You are
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And once you, wait.
[CUSTOMER][NEUTRAL] Now do I also have a oh go ahead.
[AGENT][NEUTRAL] Oh I'm just gonna let you know once you access you will have to set up a username and password and answer any questions and then you will have access to that portal.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I have indemnity insurance as well.
[AGENT][NEUTRAL] I only see that you have the gap or supplemental with us. I'm not seeing an indemnity policy.
[CUSTOMER][NEUTRAL] So all it covers is $250.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And that's the only coverage that I've got for you.
[AGENT][NEUTRAL] Yes, let me make sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, that's the only policy that I see that is active with us.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] There is no uh.
[CUSTOMER][NEUTRAL] Insurance do you?
[AGENT][NEUTRAL] That is your gap supplemental.
[AGENT][NEUTRAL] Insurance.
[CUSTOMER][NEUTRAL] OK, so all it will ever cover is $250 per incident, correct?
[AGENT][NEUTRAL] Per occurrence, correct.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][POSITIVE] Thank you very much.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life, [PII]. Have a great day.
[CUSTOMER][NEUTRAL] You as well.
[AGENT][POSITIVE] Thank you bye.