AccountId: 011433970860
ContactId: 5be73d0f-cc41-42a8-b17e-16f504d4a08f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 147259 ms
Total Talk Time (AGENT): 72836 ms
Total Talk Time (CUSTOMER): 48190 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/5be73d0f-cc41-42a8-b17e-16f504d4a08f_20250624T17:35_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, good afternoon. I'm calling because I need benefits on a patient, and I'm sorry, can I have your name again?
[AGENT][NEUTRAL] It is [PII].
[CUSTOMER][POSITIVE] Thank you [PII] how are you today?
[AGENT][POSITIVE] I'm doing good. How about you?
[CUSTOMER][POSITIVE] I'm doing good thank you.
[AGENT][NEUTRAL] You're welcome. May I please have your name and a callback number?
[CUSTOMER][NEUTRAL] Of course [PII] it's [PII].
[AGENT][NEUTRAL] And you see, may I please have the policy number?
[CUSTOMER][NEUTRAL] Of course, um, the policy number is 968024.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], uh, date of birth is [PII].
[AGENT][NEUTRAL] You're calling in for benefits, is there a specific benefit that you're calling in for?
[CUSTOMER][NEUTRAL] Yeah, I know this is his, uh, gap insurance. I needed to know the max amount, um, for his gap insurance.
[AGENT][NEUTRAL] OK, is this for inpatient, outpatient?
[CUSTOMER][NEUTRAL] For outpatient.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Outpatient services.
[AGENT][NEUTRAL] I'm pulling that information up for you now.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And verification coverage does not guarantee the payment of the claim. For outpatients, the member does have 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 does not cover any preventative or wellness. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] The effective date of the policy please.
[AGENT][NEUTRAL] Let me get that for you.
[CUSTOMER][NEUTRAL] So if he's having a pre a preventative um procedure, it won't be covered?
[AGENT][NEUTRAL] If it is for preventative or wellness, we do not cover that benefit.
[CUSTOMER][NEUTRAL] OK, so he's gonna have a screening colonoscopy. It won't be covered.
[AGENT][NEGATIVE] As if it's for preventative or wellness, it's not covered.
[CUSTOMER][NEUTRAL] OK, OK, perfect, thank you. I just need the effective date of the policy and a reference number when you have a chance please.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, and the effective date is showing 11-1 of 18 and for the call reference, it would be my first name [PII], last initial of [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you have a great day.
[AGENT][NEUTRAL] You're welcome. Thank you for calling American Public Life. Have a.