AccountId: 011433970860
ContactId: 88f265bc-a243-403d-8449-2c67c22ee50f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 161300 ms
Total Talk Time (AGENT): 82617 ms
Total Talk Time (CUSTOMER): 43859 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/88f265bc-a243-403d-8449-2c67c22ee50f_20250303T19:52_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, I'm looking for eligibility and benefits.
[AGENT][NEUTRAL] May I have your name and callback number?
[CUSTOMER][NEUTRAL] My name is [PII] calling from Florida Women's Care. Callback number [PII].
[AGENT][NEUTRAL] And may I please have the policy number?
[CUSTOMER][NEUTRAL] It's 0244899.
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy you're calling in for eligibility and benefits. Is there a specific benefit you're calling in for?
[CUSTOMER][NEUTRAL] Yes, uh, CPT code 57454.
[AGENT][NEUTRAL] Is this done within an outpatient office setting or inpatient?
[CUSTOMER][NEUTRAL] In office.
[AGENT][NEUTRAL] I'm pulling that information up for you now.
[AGENT][NEUTRAL] And verification of coverage does not guarantee the payment of the claim. For eligibility, this policy is currently active. The effective date is [PII].
[AGENT][NEUTRAL] For an office visit, the member does not cover, have that benefit, but for a procedure that is rendered within an office setting, the member does have up to $500 per calendar day.
[AGENT][NEUTRAL] Which that will cover the deductible coinsurance or co-pay for the primary, and this policy will only cover sickness and injury. It does not cover any preventative or wellness. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Um, just a question, the CPT code I gave you, it will be covered, right?
[AGENT][NEUTRAL] If it's a procedure rendered within the office that is considered a covered benefit and if it's for sickness and injury.
[CUSTOMER][NEUTRAL] OK, yes, um, you said it's 500 per calendar day.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. Can you spell your name for me, please? And I need a reference number.
[AGENT][NEUTRAL] The reference number will be my first name, [PII], which is spelled [PII] last initial of [PII] in today's date.
[CUSTOMER][POSITIVE] OK, thank you so much. Have a good day.
[AGENT][POSITIVE] You're welcome thank you for calling American Public Life. Have a great day as well.