AccountId: 011433970860
ContactId: 707353fe-cc77-4f64-ab67-e8b7913870a5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 171270 ms
Total Talk Time (AGENT): 73823 ms
Total Talk Time (CUSTOMER): 50584 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/707353fe-cc77-4f64-ab67-e8b7913870a5_20250617T16:26_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, my name is [PII]. I'm calling from the provider's office and I'm calling to get um eligibility and benefits for a patient.
[AGENT][NEUTRAL] May I please have a callback number?
[CUSTOMER][NEUTRAL] It's um [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] Yes, it is 01716855.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And you're calling in for benefits. Is there a specific benefit that you're calling in for?
[CUSTOMER][NEUTRAL] Um, yes, outpatient mental health.
[AGENT][NEUTRAL] And I'm pulling that information up for you now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And verification of coverage does not guarantee the payment of the claim. This policy is showing that it is currently active with the effective date of [PII]. For outpatient, the member has up to $2500 per calendar year that will go towards the primary insurance deductible, co-insurance, or co-pay. This policy is for sickness and injury only.
[AGENT][NEUTRAL] It does not cover any preventative or wellness. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Um, so would it not cover mental health then if since it's only sickness and injury?
[AGENT][NEUTRAL] If it's, if it's not preventative or wellness, the member has up to the $2500 per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So how would I know if that was covered or not?
[AGENT][NEUTRAL] OK, I just stated if it's not preventative or wellness, it's a covered benefits.
[CUSTOMER][NEUTRAL] Mhm. If it's not preventative. Um,
[CUSTOMER][POSITIVE] It is covered, OK.
[CUSTOMER][NEUTRAL] All right. Um, can I get a reference number for the call?
[AGENT][NEUTRAL] Yes, the reference number will be my first name, [PII], last initial of [PII] in today's date.
[CUSTOMER][POSITIVE] All right. Thank you so much for your help.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] OK