AccountId: 011433970860
ContactId: 9a53aaec-336a-4cd7-9306-9a4d0e8d56b2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 181449 ms
Total Talk Time (AGENT): 75082 ms
Total Talk Time (CUSTOMER): 85404 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/9a53aaec-336a-4cd7-9306-9a4d0e8d56b2_20250114T16:57_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] and I just have a question regarding my policy.
[AGENT][NEUTRAL] OK. May I have your policy number?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Hm, so my card has a group number.
[AGENT][NEUTRAL] It will be the outpatient benefit certification number.
[CUSTOMER][NEUTRAL] OK, so that is 01813090 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] And may I have your date of birth and your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and may I have a callback number and then your email address that's listed on file?
[CUSTOMER][NEUTRAL] [PII] um [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying your policy. How may I assist you?
[CUSTOMER][NEUTRAL] So I'm scheduled to have an MRI at a hospital. It's not an outpatient facility, and I was just informed that I'm going to have a $940 balance due. I just wanted to know if this is something that American Public Life picks up or do I need to go to a different facility in order to have it picked up?
[AGENT][NEUTRAL] OK, so is it an office setting if it's not an outpatient facility?
[CUSTOMER][NEUTRAL] It's at the hospital.
[AGENT][NEUTRAL] OK, so that would be considered outpatient.
[CUSTOMER][POSITIVE] OK, alrighty.
[AGENT][NEUTRAL] Yes. Did you need your outpatient benefits?
[CUSTOMER][NEUTRAL] I, I didn't know if it's like a standalone.
[CUSTOMER][NEUTRAL] Yeah, can you check on that for me please?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, I just wasn't sure if it had to be like a standalone where it's just an office that does that only, and not the hospital.
[AGENT][NEUTRAL] OK, so in regards to your benefits, verification of coverage does not guarantee the payment of the claim. If you have services rendered within an outpatient facility, ambulatory facility, or an office setting, you do have up to $4000 per calendar year in which that $4000 will go towards your deductible, co-insurance, or co-pay of your primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect. Alrighty, that's what I needed to know. Thank you very much. I appreciate it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm OK. Now, what you may wanna do, if you give them this information as well?
[CUSTOMER][NEUTRAL] I don't think they have it, so I will give it to them.
[AGENT][NEUTRAL] Yes, OK, and they would just contact us and we will verify that information as well with them.
[CUSTOMER][POSITIVE] OK, sounds good thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life, [PII]. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you.