AccountId: 011433970860
ContactId: 8c7936c2-ab40-49e9-bd94-cfd6261e9d80
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 308649 ms
Total Talk Time (AGENT): 100918 ms
Total Talk Time (CUSTOMER): 126657 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/8c7936c2-ab40-49e9-bd94-cfd6261e9d80_20250415T15:04_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 [PII], um, this is [PII], a patient. This is [PII] from the University of Miami. I'm here to, um, check eligibility and benefits for, uh, patients.
[AGENT][NEUTRAL] May I have a callback number please?
[CUSTOMER][NEUTRAL] It's going to be [PII] and that's a direct line.
[AGENT][NEUTRAL] And you did say your name is [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, and may I please have the policy number?
[CUSTOMER][NEUTRAL] The policy number is going to be.
[CUSTOMER][NEUTRAL] Um, 2454837 and it's going to be a meddling select group.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's going to be.
[CUSTOMER][NEUTRAL] Um, [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 that you're calling in for?
[CUSTOMER][NEUTRAL] I'm trying to see, um, I'm trying to verify, um, I'm trying to verify, OK, one is it active.
[AGENT][NEUTRAL] OK, that I'm, yes, I said eligibility and benefits, but I'm needing to know if it's what benefit are you needing for me to verify.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] I'm trying to verify the amount available for outpatients for outpatient facility.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And for this policy, verification of coverage does not guarantee the payment of the claim. It is currently active with the effective date of [PII]. For outpatient, the member has up to.
[AGENT][NEUTRAL] $2000 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] You said it's for sickness or injury?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] And it will not
[CUSTOMER][NEUTRAL] And will not um
[CUSTOMER][NEGATIVE] It will not cover um preventive.
[AGENT][NEUTRAL] Preventative or wellness?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me check on something real quick, um, and you said the amount available to use is 2000 currently correct?
[AGENT][NEUTRAL] 2000 per calendar year.
[CUSTOMER][NEUTRAL] So, has anything been used this year or no?
[AGENT][NEUTRAL] As of right now, nothing has been used.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] So, OK, perfect. Um,
[CUSTOMER][NEUTRAL] Out of curiosity, if the patient's having like an echo done.
[CUSTOMER][NEUTRAL] Would this be considered preventive or would you need a CPT code?
[AGENT][NEUTRAL] We don't process claims over the phone. It's based off of what we receive. So, only thing that I can inform you as long as it's not due to preventative or wellness and it is for sickness and injury, they do have up to that maximum amount.
[CUSTOMER][NEUTRAL] Or does it just or is it?
[CUSTOMER][POSITIVE] Perfect thank you so much and may I please get a reference number for this call?
[AGENT][NEUTRAL] Yes, the reference number will be my first name [PII], last initial of [PII] and today's date.
[CUSTOMER][NEUTRAL] OK, [PII] and then [PII] and then you said today's date?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Perfect. And then,
[CUSTOMER][NEUTRAL] Um, one last thing.
[CUSTOMER][NEUTRAL] Um, sorry, just to make sure that I'm like getting this right from my notes, 2000 available per calendar year. Nothing has to be related to sick or injury. It will not cover preventive or wellness, and then, um.
[CUSTOMER][NEUTRAL] It's currently active and available.
[AGENT][NEUTRAL] Are you asking me that question?
[CUSTOMER][NEUTRAL] Yes, just to like reverify before I leave this call.
[AGENT][NEUTRAL] Yes, it's currently active.
[CUSTOMER][POSITIVE] OK perfect thank you um thank you [PII] have a great day.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life, [PII] have a great day as well.
[CUSTOMER][NEUTRAL] You too. Bye-bye.