AccountId: 011433970860
ContactId: 525d0970-7889-4550-8604-48ee1ce8b818
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206039 ms
Total Talk Time (AGENT): 89737 ms
Total Talk Time (CUSTOMER): 170303 ms
Interruptions: 12
Overall Sentiment: AGENT=1.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/525d0970-7889-4550-8604-48ee1ce8b818_20250314T17:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Thank you for calling can I help you? This is American Public Life Insurance Company. Yes, I was, I was calling to, uh, verify, uh, if these patients have co-payment, uh, coverage.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, coverage for their copay?
[CUSTOMER][NEUTRAL] Uh, coverage for the copay.
[AGENT][NEUTRAL] Yeah, I can take a look at those benefits um what was your name?
[CUSTOMER][NEUTRAL] Yeah, I can take a look at those benefits um what was your name? A.
[AGENT][NEUTRAL] OK. And can I get
[CUSTOMER][NEUTRAL] And I and I'm calling from Miami diabetes endocrinologist.
[AGENT][POSITIVE] Thank you, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][POSITIVE] Thank you. Yes, [PII].
[AGENT][NEUTRAL] Thank you. And then did you have the policy number?
[CUSTOMER][NEUTRAL] Thank you. And then did you have the policy number? Yes, I do. The policy number will be 02342994 M like Mary L like Larry 8.
[AGENT][NEUTRAL] Thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Thank you and what was the name and date of birth for the insured? [PII], [PII].
[AGENT][POSITIVE] Perfect. Thank you for verifying all of that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] Perfect, thank you for verifying all of that, A. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays.
[CUSTOMER][NEUTRAL] Deductible copay deductible, and what else did you say?
[AGENT][NEUTRAL] And co-insurance.
[CUSTOMER][NEUTRAL] And and coinsurance, OK, OK, because see like we're a specialist endocrinologist so she comes in here, she has a copay so you guys will cover her copays or 120. Let me take a look so of course I will let you know verification coverage is not a guarantee of payment for claims, um, so for this policy offices are not covered. However, treatment received in office is. Office visit, I'm not covered.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me take a look, so.
[AGENT][NEUTRAL] Of course, I will let you know verification of coverage is not a guarantee of payment for claims. Um, so for this policy, office visits are not covered, however, treatment received in office is.
[AGENT][NEUTRAL] Correct, um, treatment in office could be. So if she had treatment in office, then that could be covered. The visit itself is not.
[CUSTOMER][NEUTRAL] Correct, um, treatment in office could be so if she had treatment in the office, then that could be covered the visit itself is not.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] Visit itself is not.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Correct. Yeah, this is what happened with patients when they have that second.
[CUSTOMER][NEUTRAL] They think that it covers the cover that a lot of the page, yeah.
[AGENT][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Yeah, some of our policies do cover office visits, but this particular one does not.
[CUSTOMER][NEUTRAL] Yeah, some of our policies do cover office visits, but this particular one does not. OK, alright.
[CUSTOMER][NEUTRAL] And you say procedure, yes, it does cover treatment in office, right?
[AGENT][POSITIVE] Yes, treatment in office is covered.
[CUSTOMER][NEUTRAL] Yes, treatment and, yes, uh, what is your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] So that's [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, [PII]
[CUSTOMER][NEUTRAL] Yes, [PII], OK. And do I have a reference number for this call?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh, so my last initial is [PII] Was there anything else I can help you with?
[CUSTOMER][POSITIVE] Reference number would just be my first name, last initial, and today's date. Uh, so my last initial is [PII] Was there anything else I can help you with? That'll be all. Thank you. Alright, thanks for calling APL. Have a great rest of your day. You too. Bye bye. Thanks for your assistance. Bye bye. Bye bye.
[AGENT][POSITIVE] Alright, thanks for calling APL. Have a great rest of your day.
[AGENT][POSITIVE] Thank you, bye bye. Of course. Bye bye.