AccountId: 011433970860
ContactId: 95192be7-3564-420b-bd4f-65f1288f3b7b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 198259 ms
Total Talk Time (AGENT): 84155 ms
Total Talk Time (CUSTOMER): 71992 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/95192be7-3564-420b-bd4f-65f1288f3b7b_20250612T13:17_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], my name is [PII]. I'm calling from the provider's office. I have a mutual patient that I need to verify, uh, eligibility and benefits for.
[AGENT][NEUTRAL] OK, could you spell your name for me please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And may I please have a callback number and then the policy number?
[CUSTOMER][NEUTRAL] Not
[CUSTOMER][NEUTRAL] [PII] uh policy number is gonna be.
[CUSTOMER][NEUTRAL] Uh, I have an outpatient benefit cert number 023449887.
[CUSTOMER][NEUTRAL] 9 M as in Mary, L as in Larry, 8.
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Uh, patient's name is gonna be uh [PII] and 6-1675.
[AGENT][NEUTRAL] And that was 234 498-799?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 02349879 M as in Mary, L as in Larry 8.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you're calling in for eligibility and benefits for this member?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is there a specific benefit that you're calling in for?
[CUSTOMER][NEUTRAL] Uh, specialist office visit.
[AGENT][NEUTRAL] OK. I'm pulling that information up for you now.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And verification of coverage does not guarantee the payment of the claim. This policy is currently active with the effective date of [PII]. The office visit fee, the.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. What do they cover? Mhm.
[AGENT][NEUTRAL] Would you like for me to continue?
[CUSTOMER][NEUTRAL] Obviously yes, I was just asking a question.
[AGENT][NEUTRAL] OK, so for the office.
[AGENT][NEUTRAL] For the office visit fee, the member does have up to.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] $500 per calendar day, which that will go towards the office procedure benefit for the primary deductible, co-insurance or co-pay.
[AGENT][NEUTRAL] Now for the office visit.
[CUSTOMER][NEGATIVE] I'm sorry, the connection is really bad. Could you repeat that please?
[AGENT][NEGATIVE] For the office visit, the member does not have any benefits.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] But for office procedures, the member does have up to $500 per calendar day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That will go towards
[CUSTOMER][NEUTRAL] OK, great. I just, uh-huh.
[CUSTOMER][NEUTRAL] We'll go towards
[AGENT][NEUTRAL] The primary insurance deductible, co-insurance, or co-pay just for the procedure only.
[CUSTOMER][NEUTRAL] What if it exceeds $500?
[AGENT][NEUTRAL] We will only pay up to the $500 towards the primary deductible.
[CUSTOMER][POSITIVE] Thank you.