AccountId: 011433970860
ContactId: a124349a-6da0-406e-a7cb-e1d7f53cd8fe
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249750 ms
Total Talk Time (AGENT): 101318 ms
Total Talk Time (CUSTOMER): 51865 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/a124349a-6da0-406e-a7cb-e1d7f53cd8fe_20250207T17:18_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, I was calling to get eligibility and benefits, please.
[AGENT][NEUTRAL] May I have your name and a callback number?
[CUSTOMER][NEUTRAL] Yes, my name's [PII] and the callback number is [PII].
[AGENT][NEUTRAL] And may I please have the policy number?
[CUSTOMER][NEUTRAL] Yes, that is 00964740.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] And you're calling in for eligibility and benefits. Is there a specific benefit you're calling in for?
[CUSTOMER][NEUTRAL] J
[CUSTOMER][NEUTRAL] How many? Um, I was actually just wanting to see if they have any co-pays for PCP specialists or urgent care visit, please.
[AGENT][NEUTRAL] OK, so is.
[AGENT][NEUTRAL] Are you checking for an urgent care or for an office PCP?
[CUSTOMER][NEUTRAL] Uh, yes, I'm checking for that, for both of those and specialists.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm pulling that information up for you now.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And I apologize, my system's running kind of slow.
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] OK, so for this policy verification of coverage does not guarantee the payment of the claim. This policy effective date is showing [PII] and currently active. For physicians, the member has up to $25 per visit, with a maximum of 4 visits per calendar year.
[AGENT][NEUTRAL] Then for urgent care, the member has up to $500 per calendar year with a maximum of 3 urgent care visits per year.
[CUSTOMER][POSITIVE] Perfect thank you um can I have the group number please?
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Yes, let me get that for you.
[AGENT][NEUTRAL] The group number is 16048.
[CUSTOMER][NEUTRAL] Thank you and just the claims address and payer ID please.
[AGENT][NEUTRAL] The mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 24-8950
[AGENT][NEUTRAL] And the electronic payer ID is 60801.
[CUSTOMER][POSITIVE] Thank you so much. If I could just get your name and a reference number, please.
[AGENT][NEUTRAL] The reference will be my first name [PII], last initial of [PII] and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much. I appreciate your help.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life Summer. Have a great day.
[CUSTOMER][POSITIVE] Thank you. Have a good weekend. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.