AccountId: 011433970860
ContactId: 867385e3-e523-42d3-a336-e483bf256867
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192899 ms
Total Talk Time (AGENT): 78776 ms
Total Talk Time (CUSTOMER): 70242 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/867385e3-e523-42d3-a336-e483bf256867_20250429T15:13_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] Yes, I'm calling regarding um a member to check when she became effective and uh.
[CUSTOMER][NEUTRAL] To check uh and to just to find information for send a claim uh to send a claim I'm sorry.
[AGENT][NEUTRAL] OK, may I have your name and then a callback number?
[CUSTOMER][NEUTRAL] My name is [PII]. Callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the provider?
[CUSTOMER][NEUTRAL] Doctor's name is [PII].
[AGENT][NEUTRAL] And may I please have the policy number?
[CUSTOMER][NEUTRAL] OK, I have.
[CUSTOMER][NEUTRAL] The hospitals benefit certification number. I, I, what is exactly what is this?
[CUSTOMER][NEUTRAL] Certificate effectively I have a group number.
[AGENT][NEUTRAL] May I have the outpatient benefit certification number?
[CUSTOMER][NEUTRAL] Oh, impatient because I'm looking for inpatient 02605470 M as in Mary, L as in Louis, number 7.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Her name is, um, the patient's name is [PII], [PII].
[AGENT][NEUTRAL] OK. And your name is [PII] as well?
[CUSTOMER][NEUTRAL] [PII], yes, I'm calling, I'm calling from the provider's office, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're calling in for eligibility for this member?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, and for this policy, thank you so much for verifying this member is currently active with the effective date of [PII]. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] What are the inpatient and outpatient benefits for this member?
[AGENT][NEUTRAL] OK, so for the outpatient is this gonna be rendered within an outpatient facility or an office setting?
[CUSTOMER][NEUTRAL] Uh, the outpatient will be in office setting and inpatient, of course, in the hospital.
[AGENT][NEUTRAL] OK, now for the office, this member does not have that benefit for any office visit or office treatment and for the inpatient verification of coverage does not guarantee the payment of the claim. The member does have up to $3000 for inpatient which goes towards the primary insurance deductible, co-insurance, or co-pay.
[AGENT][NEUTRAL] This policy is for sickness and injury only. It will not cover any type of preventative or wellness. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] That's gonna be all. Can I have a reference number for this call?
[AGENT][NEUTRAL] The reference will be my first name [PII], last initial of [PII] in today's date.
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][POSITIVE] You're welcome thank you for calling American Public Life, have a great day.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] OK.