AccountId: 011433970860
ContactId: 7686f1f9-1b8e-4ee5-80d9-a7a7b7f2853e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 423359 ms
Total Talk Time (AGENT): 130024 ms
Total Talk Time (CUSTOMER): 118331 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/7686f1f9-1b8e-4ee5-80d9-a7a7b7f2853e_20250529T13:35_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office. Can you help with my eligibility and benefits information?
[AGENT][NEUTRAL] Yes sir, I can help you with that, [PII] Could I get a callback number?
[CUSTOMER][NEUTRAL] Yes, sure.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] I'm calling you about 02258741. M as in Mary, L as in Lima.
[CUSTOMER][NEUTRAL] Number 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], and the date of birth is [PII].
[AGENT][POSITIVE] OK, thank you so much for verifying the account and you did say you were calling for benefits and eligibility today?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what is this, uh, patient coming in for? What type of service? Is it outpatient, office visit?
[AGENT][NEUTRAL] Or inpatient
[CUSTOMER][NEUTRAL] Before I need the benefits for office visits specialist.
[AGENT][NEUTRAL] Office visit, OK, specialist offices, OK. Please be advised verifying benefits does not guarantee payment. I show that his policy has been effective since [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The policy is still active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and for a physician.
[CUSTOMER][NEUTRAL] May I know the plan that which plant that you?
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Plant type, which plan does number, huh?
[AGENT][NEUTRAL] This is a supplemental gap policy.
[CUSTOMER][NEUTRAL] It's supplemental policy, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, give me a second.
[CUSTOMER][NEUTRAL] It's plan G, right?
[AGENT][NEUTRAL] It's a supplemental gap policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, may I know the benefits for specialist office visit?
[AGENT][NEUTRAL] So, uh, the policy would not cover the office visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Not cohort.
[CUSTOMER][POSITIVE] And for benefits for chemotherapy.
[AGENT][NEUTRAL] Chemotherapy would be covered with a malignant cancer diagnosis up to $1500 a calendar year.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Yes, and your benefit for.
[CUSTOMER][NEUTRAL] Surgery of patient in office and for diagnostic lab.
[AGENT][NEUTRAL] OK, for surgery, uh, outpatient or in the office, it is also covered under the outpatient benefit of $1500 a calendar year.
[AGENT][NEGATIVE] A diagnostic lab would not be covered.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. May I know the patient number's photo pocket?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] OK, this supplemental policy, right OK.
[CUSTOMER][NEUTRAL] Yeah, my second, yeah. May I know the payer ID?
[AGENT][NEUTRAL] Payer ID is 60801.
[CUSTOMER][NEUTRAL] OK. May I know the claim mailing address?
[AGENT][NEUTRAL] Mailing address for claims is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh chemotherapy and surgery, is there any uh specific visits like limited visits?
[AGENT][NEUTRAL] No, the only limitation is the dollar amount.
[CUSTOMER][NEUTRAL] OK, it's $1500 right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. May I know how much uh does uh member have?
[CUSTOMER][NEUTRAL] A
[AGENT][NEUTRAL] Available.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Till the date, how much I spend that is for chemotherapy?
[AGENT][NEUTRAL] OK, let me check that.
[AGENT][NEUTRAL] I show that Carlos has the full 1500 available.
[CUSTOMER][NEUTRAL] OK, has 1500 available. Same as for surgery, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So as you can.
[CUSTOMER][NEUTRAL] Uh, can you spell out your name, please?
[AGENT][NEUTRAL] My name is spelled [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, and the last issue?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get the call reference number for this call?
[AGENT][NEUTRAL] To reference our call, you'll use my name and today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much for the information. Have a nice day. Bye-bye.
[AGENT][POSITIVE] You have a wonderful day. Thank you for calling APL bye bye.