AccountId: 011433970860
ContactId: 4e74ce93-c306-419a-84ae-8fc3fb6acd90
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 214710 ms
Total Talk Time (AGENT): 85664 ms
Total Talk Time (CUSTOMER): 84338 ms
Interruptions: 2
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/4e74ce93-c306-419a-84ae-8fc3fb6acd90_20250417T14:32_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, my name is [PII] from Vital MD Group, and I'm calling to know the benefits for one of our patients.
[AGENT][NEUTRAL] OK, may I please have a callback number?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] It's 02570559.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][POSITIVE] And thank you so much, [PII] for verifying the policy. You're calling in for benefits for this member. Is this for inpatient, outpatient, or an office setting?
[CUSTOMER][NEUTRAL] Office setting
[AGENT][NEUTRAL] OK, I'm pulling that information up for you now.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And for this member, verification of coverage does not guarantee the payment of the claim. The member does not have the office visit benefit rider, but for treatment within an office setting, the member does have up to $6000 per calendar year.
[CUSTOMER][NEUTRAL] 2 years
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Well, I
[CUSTOMER][NEUTRAL] And that is only for hospital, not for in office?
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] As I stated, they have no office visit benefit rider, but for a procedure rendered within an office setting, the member has up to $6000 per calendar year.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Yes yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I'm, I'm sorry because I, you know, I'm sick. I don't know if you can hear my voice, so I'm like off.
[CUSTOMER][NEUTRAL] So let me see if I understand clearly for procedures in office, uh, procedures in office are covered for coinsurance or something like that or not at all? I'm sorry.
[AGENT][NEUTRAL] For procedures rendered within an office setting that member does have up to $6000 and that will go towards the primary insurance deductible, co-insurance, or co-pay.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] But for the co-pay for the office visit, it's not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, it's not cover. I, I knew it. Ah, is that good? I'm sorry, OK, um, can you just tell me your name, please?
[AGENT][POSITIVE] Oh, no problem.
[AGENT][NEUTRAL] Yes, and for the reference, it will be my first name spelled [PII] and today's date. Is there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] Perfect. No, that, that's it. I really appreciate your help and your patience.
[AGENT][POSITIVE] You're welcome. Thank you so much for calling American Public Life. Have a great day.
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Bye bye.