AccountId: 011433970860
ContactId: 666091bb-a2f7-48ba-a63f-c9ec388baa7b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 405899 ms
Total Talk Time (AGENT): 155742 ms
Total Talk Time (CUSTOMER): 147679 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/666091bb-a2f7-48ba-a63f-c9ec388baa7b_20250304T19:57_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] Oh, I don't know if I have the right number.
[CUSTOMER][NEUTRAL] A is an American public life?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So you are not um an insurance company for medical insurance, or are you?
[AGENT][POSITIVE] Yes we are.
[CUSTOMER][NEUTRAL] Are you, um,
[CUSTOMER][NEUTRAL] See what is it called.
[CUSTOMER][NEUTRAL] I, are you called IMA as well?
[AGENT][NEUTRAL] No, that's their willingness.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Their number should be listed on the card.
[CUSTOMER][NEUTRAL] Do you get calls from them, for them all the time? It sounds like it.
[AGENT][NEUTRAL] It, it gets transferred over to us cause we assist with the medical part.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um, we don't have a copy of the card. That's the problem. I don't know how we got this number.
[AGENT][NEUTRAL] Mm. I can pull their medical benefits up if need be and then I can give you IMA's number and you can contact them and verify any other benefits that are needed.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Oh yeah, that would be awesome. OK.
[AGENT][NEUTRAL] May I have your name, please?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] And may I have a callback number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have the member's policy number?
[CUSTOMER][NEUTRAL] I hope it's right. It's 025.
[CUSTOMER][NEUTRAL] 69949
[AGENT][NEUTRAL] May I have the member's first and last name and their date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And I did pull that member up. How may I assist you on their benefits?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Does he have out of state cause this does he, what are the benefits for him?
[AGENT][NEUTRAL] Now, with this policy, this is an indemnity policy, which is a limited benefit. So it does not, it's not a major medical, it's not an in or out of network policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does he have um
[CUSTOMER][NEUTRAL] So does he have, like, does he have emergency room benefits? Does he have uh hospital benefits or is it only like uh
[CUSTOMER][NEUTRAL] Uh, preventative plan.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] For the preventative and wellness, if they do have it, you will have to check with IMA on that, but I am pulling up their medical benefits for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is for emergency room?
[CUSTOMER][NEUTRAL] Uh, this particular claim that I have is for, uh, blood work. It looks like we did a COVID test on him.
[AGENT][NEUTRAL] Is this still within an office setting outpatient?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Which one? Of or outpatient?
[CUSTOMER][NEUTRAL] Uh, office setting up.
[CUSTOMER][NEUTRAL] I let me do this.
[CUSTOMER][NEUTRAL] To
[AGENT][POSITIVE] And I'm pulling that up for you now.
[CUSTOMER][NEUTRAL] And we need to
[AGENT][NEUTRAL] And for this member, it shows that their policy is active.
[AGENT][NEUTRAL] Effective date is [PII]. Verification of coverage does not guarantee the payment of the claim. For the office, the member has up to $50 per day, with a maximum of 4 days per calendar year.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] If there's an amount that is left over, that is considered as patients responsibility. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] I just need to verify the claim's mailing address that we have is correct.
[CUSTOMER][NEUTRAL] For I we're supposed to submit it to IMA Inc. right?
[AGENT][NEUTRAL] Yes, she was submitted to them first and then they were submitted over to us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Is the correct mailing address [PII]?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, and then what is the correct number that I'm supposed to be calling to talk to IMA?
[AGENT][NEUTRAL] And let me get that num the number for you and also give you that policy number for that member.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] For IMA if it's listed I could be wrong.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, cause he didn't give us a, a copy of the card.
[AGENT][NEUTRAL] And I did give you this member's policy number for us, correct?
[CUSTOMER][NEUTRAL] Uh, no, I only have that one that I gave you, the 025 number.
[AGENT][NEUTRAL] OK, that's the one for us. OK. Now to contact IMA that is 1-800.
[AGENT][NEUTRAL] 833.
[AGENT][NEUTRAL] 4296.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then the policy number you said for IMA we should be using is different?
[AGENT][NEUTRAL] Yes, they have a different number and they may have a totally different one that we have, so you may have to give them the first and last name and they may have a correct policy number for them.
[AGENT][NEUTRAL] Because this one could have this one probably is not the policy number that they use that we have on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'll give them a call and see what they say.
[AGENT][NEUTRAL] OK, and is there anything else that I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] Uh, no, that's it. Thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you, bye.