AccountId: 011433970860
ContactId: 8b27ae54-0c3d-48ef-8188-ae314b6463ad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241440 ms
Total Talk Time (AGENT): 75259 ms
Total Talk Time (CUSTOMER): 156811 ms
Interruptions: 4
Overall Sentiment: AGENT=1.2, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/8b27ae54-0c3d-48ef-8188-ae314b6463ad_20250424T18:11_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] Hey, this is [PII] calling from Laser Center of Miami, and I'm calling because one of your guys is, uh, like individuals, they, they have your insurance, and I'm trying to see if they get covered. There's supposed to be a secondary with the United Healthcare.
[AGENT][NEUTRAL] OK, may I have a callback number and then the policy number?
[CUSTOMER][NEUTRAL] Yes ma'am, it is.
[CUSTOMER][NEUTRAL] [PII]. That's our phone number.
[CUSTOMER][NEUTRAL] And then the policy number is 0237.
[CUSTOMER][NEUTRAL] 3180.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, his, her name is [PII] [PII] And then you said her date of birth? Uh [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII] or [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Just if you can try to put in the latest, but I put in a note here on the surgery date to see when she does call to confirm to try to give you.
[AGENT][NEUTRAL] And you're needing benefits, is this for inpatient, outpatient or an office setting?
[CUSTOMER][NEUTRAL] It's for an office visit. She's a, um, a, a follow up.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] I'm pulling those benefits up for you now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And verification of coverage does not guarantee the payment of the claim. It does show that this policy is currently active with the effective date of [PII] for office, the member has up to $25 per visit with a maximum of 4 visits per calendar year.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Um, yeah, I, I'm not, so, so I, I don't understand. I'm so sorry. So is it, would that cover her, her, um, like primary insurance or her deductible or something cause it says that like, oh I'm sorry, I'm trying to see if it it'll cost, huh.
[AGENT][NEUTRAL] The $25 go ahead.
[AGENT][NEUTRAL] Wait,
[CUSTOMER][NEUTRAL] No, I was, I was trying to see if it's gonna cover, if it's gonna cover her $75 deductible with us.
[AGENT][NEUTRAL] For this policy, it will cover up to $25 with 4 visits for the primary insurance deductible, co-insurance, or co-pay.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] And you say up to 4 times a year.
[AGENT][NEUTRAL] Yes, for 25, yes.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So that I'm I'm a little nervous. So then technically then since it's 75 it would be 50 then is what I would tell her, right?
[AGENT][NEUTRAL] That's the provider's discretion, but we will only pay the 25.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] That's perfect. OK, that's fine. So then she is covered, but then that would be like what, like 70s like other coverage, right?
[CUSTOMER][NEUTRAL] Just $25.
[CUSTOMER][NEUTRAL] I don't think so, yeah.
[AGENT][NEUTRAL] We would
[CUSTOMER][NEUTRAL] I'm sorry, OK, and then what's her deductible met?
[AGENT][NEUTRAL] I'm sorry, could you repeat that?
[CUSTOMER][NEUTRAL] Is her deductible amount?
[AGENT][NEUTRAL] She doesn't have a deductible with us. We're, we're just a gap or supplemental, so it's based off of the primary insurance.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, I got you, thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] You have a great day.
[CUSTOMER][POSITIVE] No, no, we're good.
[AGENT][POSITIVE] Thank you for calling American Public Life. Have a great day. Bye bye.
[CUSTOMER][POSITIVE] Thank you.