AccountId: 011433970860
ContactId: 57856c23-926e-4bcd-9136-35db0dbbb507
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 170990 ms
Total Talk Time (AGENT): 82461 ms
Total Talk Time (CUSTOMER): 61146 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/57856c23-926e-4bcd-9136-35db0dbbb507_20250219T14:12_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I'm calling for benefits for a patient that we have in common.
[AGENT][NEUTRAL] OK, I can help you with that, [PII] and could I get a callback number?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[CUSTOMER][NEUTRAL] Direct line.
[AGENT][NEUTRAL] Thank you. And what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] Of course, give me one moment.
[CUSTOMER][NEUTRAL] The policy number is 01659639 M as in Mike C as in Charlie 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] He's being [PII] on [PII].
[AGENT][POSITIVE] Thank you so much for verifying the policy. And you did say benefits. What type of service is the patient coming in for?
[CUSTOMER][NEUTRAL] Um, it's, I would like to know if you cover up, uh, outpatient diagnostic services for this number.
[AGENT][NEUTRAL] OK, yes, please advise verifying benefits is not guaranteed payment. I show for outpatient benefits, the policy pays up to $7900 a calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It looks like uh let me see if anything's been used.
[AGENT][NEUTRAL] I show the full amount is available at this time. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Yes, I will let you know you pick up all the deductibles, the co-pays and the co-insurance for the patients from the primary.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, for outpatient. If it's a physician, are these services done in the physician's office?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] In the specialist office, for example.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] OK. So for the, if it's, if patient responsibility is applied to the physician office.
[AGENT][NEUTRAL] Um, service that would not be covered, but if it's applied to the treatment, then yes, it would pick up co-pay uh co-insurance and deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And an office visit for a specialist will be covered by you guys?
[AGENT][NEUTRAL] The office visit is not a covered benefit.
[CUSTOMER][NEUTRAL] OK. Um, may I have please, uh, just for the last, uh, thing, uh, the effective date of the patient with you?
[AGENT][NEUTRAL] Uh, let me get to that.
[AGENT][NEUTRAL] Policy is effective since [PII] and still active.
[CUSTOMER][NEUTRAL] OK. OK, no problem. May I have the reference number?
[AGENT][NEUTRAL] To reference the call, you'll use my name and today's date.
[CUSTOMER][POSITIVE] Excellent. Thank you so much.
[AGENT][POSITIVE] You're welcome. You have a wonderful day and thank you for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Mm bye-bye. Thank you.