AccountId: 011433970860
ContactId: 89be6baa-f8d7-41ad-b9e5-b153ad90fb87
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195800 ms
Total Talk Time (AGENT): 64041 ms
Total Talk Time (CUSTOMER): 112181 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/89be6baa-f8d7-41ad-b9e5-b153ad90fb87_20250206T13:46_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, my name is [PII] I'm calling from Milan Eye Center. We're a medical facility at the specialist level for ophthalmology. I'm calling to verify eligibility for a patient.
[AGENT][NEUTRAL] I can verify eligibility. May I have the policy number?
[CUSTOMER][NEUTRAL] 02548554 [PII].
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And may I have a good callback number for you, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and thank you for verifying that information. This plan is effective [PII] and it is active.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And is this a, we have two conflicting things. Um, is this a gap secondary plan or just a regular secondary medical plan?
[AGENT][NEUTRAL] It is a gap plan. It will pick up the copays, the co-insurance and or deductibles up to the benefit amount.
[CUSTOMER][NEUTRAL] OK, it is a gap plan.
[CUSTOMER][NEUTRAL] And it will pick up co-pays, would you say copays, deductibles, and what else? And
[AGENT][NEUTRAL] Co and coinsurance.
[CUSTOMER][NEUTRAL] OK, so this is secondary to Blue Cross Blue Shield Primary with a $60 co-pay. Is it gonna pick up the primary co-pay of $60 from Blue Cross Blue Shield?
[AGENT][NEUTRAL] Please be advised that verification of coverage does not guarantee the payment of a claim. So, normally, yes, but under this particular plan, she does not have the office visit, nor does she have the office treatment benefit.
[CUSTOMER][NEUTRAL] OK, so this plan does not have office treatment.
[AGENT][NEUTRAL] Or office visit.
[CUSTOMER][NEUTRAL] Or office.
[CUSTOMER][NEUTRAL] Our office visit coverage.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] OK, so it will not, will not pick up.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] The primary. OK, got it. OK, can I get a reference number for this um call, please?
[AGENT][NEUTRAL] Yes, it will be my name which is [PII] Last initial is [PII] along with today's date.
[CUSTOMER][NEUTRAL] And um let me read this back to you just real quickly for since she's, she's calls in a lot. So this is active 91248 a gap plan. It will pick up copays, deductible and co-insurance. This plan does not have office treatment or office visit coverage, so it will not pick up the primary copay. And then the reference number is Monique with today's date. What was your last initial?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK, thank you so much. I appreciate your help with this.
[AGENT][POSITIVE] [PII], you're so welcome. And thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Thank you. Uh-huh, bye-bye.