AccountId: 011433970860
ContactId: 4a59b3b2-5dc9-40af-a796-05dc391867dd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188000 ms
Total Talk Time (AGENT): 77850 ms
Total Talk Time (CUSTOMER): 87284 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/4a59b3b2-5dc9-40af-a796-05dc391867dd_20250508T14:07_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. My name is [PII]. I'm calling from your provider's office trying to get benefits on a member.
[AGENT][POSITIVE] OK, well, I can definitely help you with the benefits and you said your name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, and [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and the policy number is 02611439.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and then I have [PII] secondary.
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills? I'm sorry, you said the benefits. I'm looking for a claim. I'm sorry, hold on one moment.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, I'm just getting general benefits.
[AGENT][NEUTRAL] OK, for outpatient?
[CUSTOMER][NEUTRAL] Um, yes, for office setting.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So the policy will pay up to
[AGENT][NEUTRAL] $6500 per calendar year for outpatient services.
[AGENT][NEUTRAL] And that does include treatment in a physician's office, which also includes the specialist's office.
[CUSTOMER][NEUTRAL] You said 6500 per calendar year and that is um co-payments, it covers the co-payments, deductibles, co-insurance in office.
[AGENT][NEUTRAL] Correct. Mhm. Um, did you want me to see if any of that balance has been used for this year?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, hold on one moment. So I'm not showing um that any of the benefits have been used for [PII], so they still have the full 6500.
[CUSTOMER][NEUTRAL] OK. And when did this insurance become effective?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, I do have one more question because I wanna make sure that we are, I don't have a picture, um, the card, the physical card, um.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] So the PO box this is American Public Life Insurance, correct?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] And the PO box is 248,950 with a payer ID of 60801, is that correct?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, alright, perfect. And may I just have a reference number for this call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Use my name
[CUSTOMER][POSITIVE] And what was your first name again? I'm so sorry.
[AGENT][NEUTRAL] It's OK. My name is [PII]
[CUSTOMER][POSITIVE] OK thank you have a nice day bye.
[AGENT][NEUTRAL] Yeah, so just