AccountId: 011433970860
ContactId: 63d55a66-2fbb-4f2c-82cb-c7429dc85de4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 182529 ms
Total Talk Time (AGENT): 59834 ms
Total Talk Time (CUSTOMER): 69095 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/63d55a66-2fbb-4f2c-82cb-c7429dc85de4_20250109T17:46_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, hi [PII], good afternoon. I'm calling for eligibility and benefit for a patient.
[AGENT][POSITIVE] OK, I'm happy to check eligibility and benefits today. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] This is American Public Life Insurance. Am I correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Um, member ID is 02549483.
[AGENT][POSITIVE] Thank you. And if I could get your first name and a callback number, please?
[CUSTOMER][NEUTRAL] [PII] callback number is [PII]. And [PII], can I have the first letter of your last name?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Thank you [PII]. And if I could get the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that. So the patient is active. The effective date is [PII]. This is their secondary insurance. This will cover deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does it follow Medicare guidelines?
[CUSTOMER][NEUTRAL] I know.
[AGENT][NEUTRAL] Yeah, so it's gonna cover any sort of deductible, co-pay or co-insurance that their primary insurance does not. Their outpatient benefit max for the calendar year is 6000.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] 6000.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And how much have have been used as of today?
[AGENT][NEUTRAL] On money.
[AGENT][NEUTRAL] Patient hasn't used anything to date.
[CUSTOMER][NEUTRAL] And is um televisit with the.
[CUSTOMER][NEUTRAL] Does telehealth consultation with a specialist.
[CUSTOMER][NEUTRAL] Is that covered?
[AGENT][NEUTRAL] It would be under outpatient benefits, yes.
[CUSTOMER][NEUTRAL] It is covered
[AGENT][POSITIVE] Correct, under outpatient.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] Alright, alright.
[CUSTOMER][NEUTRAL] All right, uh, can I have a reference number?
[AGENT][NEUTRAL] Call reference is my name with my last initial and then today's date.
[CUSTOMER][POSITIVE] All right, that will be all thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Have a good day.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.