AccountId: 011433970860
ContactId: 50960695-e33c-47d3-a212-343658df2827
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240720 ms
Total Talk Time (AGENT): 99354 ms
Total Talk Time (CUSTOMER): 70855 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/50960695-e33c-47d3-a212-343658df2827_20250103T19:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I'm calling from Pisa Medical Clinic, and I'm hoping you can help me verify benefits for a patient.
[AGENT][NEUTRAL] I can verify benefits [PII]. May I have a policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02570013.
[AGENT][POSITIVE] Thank you and may I have a good callback number for you?
[CUSTOMER][NEUTRAL] Yeah, so it's [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. Is this for medical, dental?
[CUSTOMER][NEUTRAL] Yeah, for medical.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, let me get this medical policy pulled up. Looks like the medical policy number is 02570012.
[AGENT][NEUTRAL] Let me get that pulled up.
[AGENT][NEUTRAL] This is a hospital indemnity plan. It is a limited benefit plan. So one moment, just waiting on it to load.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It is still loading. I do apologize. Which benefit can I verify for you?
[CUSTOMER][POSITIVE] All right. Thank
[CUSTOMER][NEUTRAL] Um, it looks like it's an in office lab benefit.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] I do apologize, it's extremely slow.
[CUSTOMER][NEUTRAL] It appears she had a lab visit and an office visit as well.
[AGENT][NEUTRAL] OK. These plans do not have a copay, only the benefit amount. They do have 4 visits per calendar year under the office treatment. I'm just looking for
[AGENT][NEUTRAL] The amount allowed looks like they're allowed $50 per visit 4 visits per calendar year. So that $50 will include any treatment received in the office as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and the policy the number number for this patient was 02570012.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, I think I had a 3 at the end of it, so that might be where.
[CUSTOMER][NEUTRAL] My clean field at the clearing house, so I bet that would be why.
[AGENT][NEUTRAL] And that
[AGENT][NEUTRAL] Yes, and that is actually their dental policy.
[CUSTOMER][POSITIVE] OK all right well I will get this updated and send it back on through. I appreciate your time today.
[AGENT][POSITIVE] You are so welcome, [PII]. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Nope, I think I'm all set.
[AGENT][POSITIVE] Well, thank you for calling American Public Life, [PII]. Have a great weekend. Bye bye.
[CUSTOMER][POSITIVE] Thank you. You as well. Bye-bye.
[AGENT][POSITIVE] Thank you.