AccountId: 011433970860
ContactId: 4930c266-43fe-4eb3-b6f1-4e1bdc8ed182
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 211520 ms
Total Talk Time (AGENT): 79255 ms
Total Talk Time (CUSTOMER): 40566 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/4930c266-43fe-4eb3-b6f1-4e1bdc8ed182_20250207T20:59_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'm calling to verify um the gap policy for outpatient benefits for patients.
[AGENT][NEUTRAL] May I have your name and a callback number?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] And may I please have the policy number?
[CUSTOMER][NEUTRAL] Policy number is 60801.
[CUSTOMER][NEGATIVE] I don't know if that's right.
[AGENT][NEUTRAL] OK, that's our electronic payer ID. I would need the outpatient benefits certification number listed on the card.
[CUSTOMER][NEUTRAL] Uh, would that be 14793? I don't have the card in front of me.
[AGENT][NEGATIVE] That's not enough numbers.
[CUSTOMER][NEUTRAL] Could I give you the member ID? I mean, um, name and date of birth?
[AGENT][NEUTRAL] I'm trying to see if that's the group number that you just gave me.
[AGENT][NEUTRAL] May I have the member's first and last name please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] May I have the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you're calling in for benefits for this member?
[CUSTOMER][NEUTRAL] Yes, for outpatient hospital, ambulatory surgery.
[AGENT][NEUTRAL] And I'm pulling that information up for you now.
[AGENT][NEUTRAL] And for this policy, the correct policy number is 02.
[AGENT][NEUTRAL] 42
[AGENT][NEUTRAL] 4711.
[AGENT][NEUTRAL] And it does show that the policy is, you're welcome, is currently active. The effective date is [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And verification of coverage does not guarantee the payment of the claim. For outpatient, the member has up to $5500 per calendar year that will go towards the primary insurance deductible, co-insurance, or co-pay. This policy is for sickness and injury only. It will not cover any preventative or wellness. Is there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Will the patients still have that amount available or they use some of it?
[AGENT][NEGATIVE] As of right now, showing the member has not used any of their benefits.
[CUSTOMER][NEUTRAL] OK, thank you. And can I get the first initial of your last name for a reference?
[AGENT][NEUTRAL] It is [PII].
[CUSTOMER][POSITIVE] All right, thank you so much have a great weekend.
[AGENT][POSITIVE] You're welcome and thank you for calling American Public Life. Have a great weekend as well.
[CUSTOMER][POSITIVE] Thank you.