AccountId: 011433970860
ContactId: 625bf06e-a29c-4fce-b635-61460a6009bd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 279760 ms
Total Talk Time (AGENT): 124600 ms
Total Talk Time (CUSTOMER): 146780 ms
Interruptions: 3
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/625bf06e-a29c-4fce-b635-61460a6009bd_20250409T19:59_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] So that
[CUSTOMER][NEUTRAL] You're gonna get
[CUSTOMER][NEUTRAL] Hello, this is [PII]. I'm calling you here from a provider's office. I was wondering if this insurance was like for hospital, dental, gap? Is it for office visits or no?
[AGENT][NEUTRAL] I would have to check the benefits. May I get your name and a callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, it will be [PII] and then [PII].
[CUSTOMER][NEUTRAL] OK, and then callback number for the office would be [PII].
[AGENT][NEUTRAL] A callback number?
[AGENT][NEUTRAL] Thank you. And the policy number you're calling on?
[CUSTOMER][NEUTRAL] It would be policy 02596760.
[AGENT][NEUTRAL] Mm, OK, that's too many numbers for our policy number.
[CUSTOMER][NEUTRAL] Yeah, that's a one.
[AGENT][NEUTRAL] You said 25.
[CUSTOMER][NEUTRAL] And I have 02596760.
[AGENT][NEUTRAL] OK. Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth for this patient is [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying the policy. And you say you're calling to see if this policy covers office visits and what type of coverage it is?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, a specialist office visit. Yes, and what type of coverage because the patient just gave it to me right now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, please be advised verifying benefits is not guaranteed payment. The policy is effective. It's been effective since [PII].
[CUSTOMER][NEUTRAL] But it could be the first
[AGENT][NEUTRAL] Um, so this is the supplemental gap policy. Uh, it looks like, uh, the policy would not cover the office visit.
[CUSTOMER][NEUTRAL] And your last name, please?
[AGENT][NEUTRAL] However, if other treatment is rendered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The policy will cover the other treatment, the other treatment in the office, but not the office visit expenses.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] OK, so is this like a secondary insurance that he has, or?
[AGENT][NEUTRAL] It is a secondary supplemental gap policy.
[CUSTOMER][NEUTRAL] So it's a secondary.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] Mm, OK. Does this have a deductible?
[AGENT][NEUTRAL] No, so it does pay secondary um towards deductible co-pay and co-insurance from the primary, um, for other treatment in the office that would be covered under the outpatient benefit, paying up to $2550 a calendar year and please be advised verifying benefits does not guarantee payment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] OK, so he, he's a policy holder also, right?
[AGENT][NEUTRAL] He is the policyholder, yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so it is a secondary insurance.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] be
[CUSTOMER][NEUTRAL] So it doesn't have like a deductible or copay, nothing like that, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEGATIVE] And no out of pocket also.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Your name?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] OK, [PII], does he required, for example, noo no referrals correct also? OK.
[AGENT][POSITIVE] That is correct. No uh or referral required.
[CUSTOMER][NEUTRAL] Let me have
[CUSTOMER][NEUTRAL] OK, can I have the reference number, please?
[AGENT][NEUTRAL] Sure, to reference the call, you'll use my name in today's date.
[CUSTOMER][NEUTRAL] Take 4925.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh what else?
[CUSTOMER][NEUTRAL] Can I have the claim address please?
[AGENT][NEUTRAL] Mailing address for claims is [PII].
[CUSTOMER][NEUTRAL] You know.
[CUSTOMER][NEUTRAL] OK, so we're in the same parking lot and let me have the zip code again, sorry.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. You have a wonderful day, [PII]. Thank you for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Have a nice day, ma'am. You too thank you bye bye.