AccountId: 011433970860
ContactId: a04cef4c-427b-443f-9f5d-384d56e78737
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 175899 ms
Total Talk Time (AGENT): 59420 ms
Total Talk Time (CUSTOMER): 100074 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/a04cef4c-427b-443f-9f5d-384d56e78737_20250116T18:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. I'm not actually sure if I uh selected the correct department. I'm calling from a mental health provider's office because one of our patients stated that they have American public life as a secondary.
[CUSTOMER][NEUTRAL] And I wanted to find out if American public will cover um for mental health claims and also determine where the claims should be submitted.
[AGENT][POSITIVE] Hey, yes, ma'am. I can assist you with benefits. Um, first, can I get your name again and a good callback number?
[CUSTOMER][NEUTRAL] Sure, my name is [PII].
[CUSTOMER][NEUTRAL] first initial of my last name is [PII].
[CUSTOMER][NEUTRAL] And phone number is going to be area code [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Sure. 0245488889.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] OK. The patient is [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] OK. Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And is this for inpatient or outpatient benefits, or will the services take place in an office?
[CUSTOMER][NEUTRAL] It would be office.
[AGENT][NEUTRAL] OK. Oh, actually, under this policy, services provided in office is not covered. Um, I'm only showing coverage for inpatient and outpatient hospital.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] All right, and that's why I actually when I called, I said I wasn't sure if I uh selected the correct department because it didn't give me any other options. OK, so she only has coverage for inpatient and outpatient hospital.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] OK, [PII]. All right. Well, thank you very much for your time. I really do appreciate it.
[AGENT][POSITIVE] Oh, no problem. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Well, I don't think so, um, cause, like I said, if, you know, if she doesn't have coverage for office visits, it, there's really nothing more that you can do, but I do appreciate the information and your time.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] OK, no problem, [PII]. You have a great rest of your day and thanks for calling ATL.
[CUSTOMER][POSITIVE] Oh, you do the same, Evi. Thank you.
[AGENT][POSITIVE] Mhm. You're welcome. Mm bye.
[CUSTOMER][NEUTRAL] Bye bye.