AccountId: 011433970860
ContactId: 536ada26-d229-4106-a2c2-ba67d903be78
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223110 ms
Total Talk Time (AGENT): 92292 ms
Total Talk Time (CUSTOMER): 85666 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/536ada26-d229-4106-a2c2-ba67d903be78_20250311T19:24_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] Uh, hi, uh, I am calling, uh, to find out benefits. Um, our patient has the American Public Life policy is secondary. I'm trying to find out, uh, what the coverage is. She is having a procedure, uh, an upper endoscopy.
[AGENT][NEUTRAL] OK, may I have your name and a callback number?
[CUSTOMER][NEUTRAL] Sure, it's uh first name is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And how do you spell yours?
[AGENT][NEUTRAL] It is spelled [PII] and today's date would be the call reference. May I please have the callback number?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Yes, my direct line is [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] Yes, it is 1445851 letters M as in Mary, L as in Larry and number 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's uh [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And you're calling in for benefits, is this for inpatient, outpatient or an office setting?
[CUSTOMER][NEUTRAL] Uh, no, this is gonna be for outpatient. She's having an upper endoscopy.
[CUSTOMER][NEUTRAL] Do you need the code?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And the member does have a new policy number. Are you ready for that?
[CUSTOMER][NEUTRAL] Oh, a new one? OK.
[AGENT][NEUTRAL] That policy number is 01.
[AGENT][NEUTRAL] 936826 and it is showing that this policy is currently active with the effective date of [PII] and for the outpatient benefits verification of coverage does not guarantee the payment of the claim.
[AGENT][NEUTRAL] The member has up to $500 per calendar day 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 preventive or wellness. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] They don't cover up to 500, let's say she's got Blue Cross Blue Shield as the primary, so whatever Blue Cross and Blue Shield does not cover, hopefully that 500 will pick it up.
[AGENT][NEUTRAL] As long as it's for the deductible, co-insurance, or co-pay.
[CUSTOMER][NEUTRAL] So it's not for the procedure then?
[AGENT][NEUTRAL] If the primary insurance applies to the deductible, co-insurance, or co-pay, we will pay up to the $500 per day.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Got you. OK, let me write those in there too.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Sounds good alrighty.
[CUSTOMER][POSITIVE] Very good thank you for the information.
[AGENT][NEUTRAL] And it
[AGENT][POSITIVE] You're welcome and I do wanna thank you so much for calling American Public Life. Have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you bye.