AccountId: 011433970860
ContactId: 785b6f44-5ded-4302-91f2-46a226d5b599
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 274369 ms
Total Talk Time (AGENT): 115195 ms
Total Talk Time (CUSTOMER): 200564 ms
Interruptions: 12
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/785b6f44-5ded-4302-91f2-46a226d5b599_20250113T20:05_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] Thank you for calling American. Hi, uh, good afternoon. I'm calling from Cyprus Dermatology. I just wanted to verify, um, eligibility and benefits.
[AGENT][NEUTRAL] May I please have your name and a callback number?
[CUSTOMER][NEUTRAL] Sure, uh, my name is [PII]. I'm, um, my callback number is [PII].
[AGENT][NEUTRAL] And that was [PII]
[CUSTOMER][NEUTRAL] Um, [PII], mhm.
[AGENT][POSITIVE] [PII], thank you.
[AGENT][NEUTRAL] And may I please have the policy number?
[CUSTOMER][NEUTRAL] And may I please have the policy number?
[CUSTOMER][NEUTRAL] Um, sure, that is 01940936 ML 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] May I have the patient's name and date of birth? Mhm. It's [PII]. Date of birth [PII].
[AGENT][NEUTRAL] And you're calling in for eligibility and benefits, is there a specific benefit that you're calling in for?
[CUSTOMER][NEUTRAL] Uh, yes, please. So, um, for a specialist office visit and outpatient surgery in an office.
[AGENT][NEUTRAL] OK. So is it going to be, are you saying that the surgery will be rendered within an office setting or is it done within an outpatient facility?
[CUSTOMER][NEUTRAL] So is it going to be, are you saying that the surgery will be rendered within an office setting or is it done within an outpatient facility?
[CUSTOMER][NEUTRAL] Um, it's gonna be done in an office, um, but, um, can also be considered outpatient. Um, also just a general benefit, um, they don't have anything scheduled for surgery.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] I'm pulling the office procedure and office visit benefits up for you now.
[CUSTOMER][NEUTRAL] the office procedure and office visits up for you now, OK.
[AGENT][NEUTRAL] And verification of coverage does not guarantee the payment of the claim. This member does have a new policy number. Are you ready for that?
[CUSTOMER][NEUTRAL] And verification of coverage does not guarantee the payment of the claim if member does have a new policy number are you ready for this? Oh yes please.
[AGENT][NEUTRAL] It is 02.
[CUSTOMER][NEUTRAL] It is 0210.
[AGENT][NEUTRAL] 10
[AGENT][NEUTRAL] 7801. It is showing that it's currently active. The effective date is [PII].
[CUSTOMER][NEUTRAL] 7801 it is showing that it's currently active. The effective date is [PII].
[AGENT][NEUTRAL] For office visits and or procedures, the member does not have the office visit benefit rider, but for a procedure rendered within an office setting, the member has up to $500 per calendar year that will go towards the primary insurance deductible, co-insurance, or co-pay. This policy is for sickness and injury only. It will not cover any preventative or wellness. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] For office visits and procedures, the the procedure within an office setting, the has up to $500 per year that will go towards the primary insurance deductible, coinsurance, or co-pay.
[CUSTOMER][NEUTRAL] This policy is for sickness and injury only. It will not cover any preventative or wellness.
[CUSTOMER][NEUTRAL] Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Um, so just to verify, so they don't have specialist office visit benefits, so they're gonna.
[CUSTOMER][NEUTRAL] Uh, pay out of pocket?
[AGENT][NEUTRAL] They don't have the office visit benefit rider for the office visit fee, but they do have any procedure that is rendered within an office setting up to that $500.
[CUSTOMER][NEUTRAL] They don't have the office visit benefit rider for the office visit fee, but they do have any procedure that is rendered within an office setting up to that $500.
[CUSTOMER][NEUTRAL] So surgery, uh, up to $500 correct?
[AGENT][NEUTRAL] Anything rendered within an office setting.
[CUSTOMER][NEUTRAL] Anything rented within an office fee.
[AGENT][NEUTRAL] Other than the visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm, hold on.
[CUSTOMER][NEUTRAL] In an office.
[CUSTOMER][NEUTRAL] Setting
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, so, uh, what is the co-insurance? Did you say they had one?
[AGENT][NEUTRAL] No, where they're supplemental. So if they have anything.
[CUSTOMER][NEUTRAL] You know, where they're supplemental.
[CUSTOMER][NEUTRAL] So if they have anything.
[AGENT][NEUTRAL] That will be going towards deductible co-insurance or co-pay, co-pay, you will have to check with them.
[CUSTOMER][NEUTRAL] That will be going towards the coin insurance copay copay you have to check with them.
[CUSTOMER][NEUTRAL] Oh, OK, so you're just the supplemental.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, sorry, didn't know that. So do they have um.
[CUSTOMER][NEUTRAL] So you're the secondary, correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] They have another primary insurance? OK, got it.
[CUSTOMER][NEUTRAL] Alright, uh, may I have the reference number for the call?
[AGENT][NEUTRAL] The call reference will be my first name [PII], last initial of [PII] and today's date.
[CUSTOMER][NEUTRAL] The call reference will be my first name [PII], last initials of [PII] in today's.
[CUSTOMER][POSITIVE] OK, thank you so much for your help appreciate it.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day.
[CUSTOMER][POSITIVE] You're welcome. Thank you for calling American.
[CUSTOMER][NEUTRAL] You too bye bye.