AccountId: 011433970860
ContactId: a364b252-b01d-4ab3-91fe-fe74523c9607
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 301779 ms
Total Talk Time (AGENT): 99588 ms
Total Talk Time (CUSTOMER): 89542 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/a364b252-b01d-4ab3-91fe-fe74523c9607_20250131T14:56_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning, um, I wanted to get some, um, eligibility and benefits for a patient and that attends our clinic.
[AGENT][NEUTRAL] OK, may I have your name and a callback number?
[CUSTOMER][NEUTRAL] OK, give me one second.
[CUSTOMER][NEUTRAL] You would need the the corporate number is that what you said?
[AGENT][NEUTRAL] I'm needing your name and a call back number just in case the call is disconnected.
[CUSTOMER][NEUTRAL] Oh OK, my name is [PII] and the number is [PII].
[AGENT][NEUTRAL] And [PII], may I please have the policy number?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, give me one second.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Hello [PII], are you still there?
[CUSTOMER][NEUTRAL] OK, so the number I have here is 19,410.
[AGENT][NEUTRAL] 19,410.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, that's not a policy number, it is either gonna be the outpatient benefit certification number listed on the card.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Would it be the one that says payer ID? I'm sorry?
[AGENT][NEUTRAL] Do you see outpatient benefit cert or inpatient benefit cert?
[CUSTOMER][NEUTRAL] That's all I
[CUSTOMER][NEUTRAL] Oh, outpatient benefit certain number right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so it's 024.
[CUSTOMER][NEUTRAL] 7882.
[CUSTOMER][NEUTRAL] 3 M.
[CUSTOMER][NEUTRAL] 08.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is her name. Last name is [PII]. First name [PII].
[CUSTOMER][NEUTRAL] And date of birth is [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] Yes, physical therapy.
[AGENT][NEUTRAL] And this is done within an office setting or outpatient facility.
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] And I'm pulling that information up for you now.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome, and verification of coverage does not guarantee a payment of the claim. This policy is showing currently active. The effective date is for 1 of 24 for outpatient, the member has up to $2000 per calendar year in which that will go towards the primary insurance deductible, co-insurance, or co-pay.
[AGENT][NEUTRAL] 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] Uh, give me one second. So the patient has no copay, is that correct?
[AGENT][NEUTRAL] This is their supplemental you would check with that for their primary.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] No, so the patient has no responsibility, correct?
[AGENT][NEUTRAL] We will pay up to $2000 per calendar year towards the primary deductible co-insurance or co-pay. You will have to check with the primary insurance for any other information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.