AccountId: 011433970860
ContactId: a52a2841-b576-4afa-b25f-c314a82ff8da
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 222800 ms
Total Talk Time (AGENT): 99714 ms
Total Talk Time (CUSTOMER): 95872 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/a52a2841-b576-4afa-b25f-c314a82ff8da_20250121T20:56_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] Good afternoon, ma'am. My name is [PII]. I'm calling from the office of Doctor [PII], ear, nose and throat. I need to verify benefits for patient, please.
[AGENT][NEUTRAL] OK, may I please have a callback number?
[CUSTOMER][NEUTRAL] Of course, that's gonna be [PII].
[AGENT][NEUTRAL] And may I please have the policy number?
[CUSTOMER][NEUTRAL] Yes, ma'am. 015309.
[CUSTOMER][NEUTRAL] 09, Mary, Larry, and the number 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Station is [PII] [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy. You're calling in for benefits is that for outpatient inpatient, or an office?
[CUSTOMER][NEUTRAL] Office, ma'am.
[AGENT][POSITIVE] OK. I'm pulling that up for you now.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And for this policy verification of coverage does not guarantee the payment of the claim. This policy is showing that it's currently active, effective date is for [PII]. For the office visit fee, the member does not have that benefit, but for a procedure rendered within an office setting, the member has up to $2500 per calendar year.
[AGENT][NEUTRAL] That will go towards the primary insurance deductible, co-insurance, or co-pay for that procedure. This policy is only for sickness and injury only. It does not cover any preventative or wellness. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] OK, so you said the effective date is for [PII] to present. Um, he has a maximum of 2500. I may go towards, um, deductible.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Deductible co-insurance or co-pay?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, deductible, co-insurance, and co-pay you said?
[AGENT][NEUTRAL] Yes, now the co-pay is only for the procedure written within an office setting, not the office visit.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that was gonna be my question. So if you already have an office copay, I collect that. However, if there is any coinsurance, deductible co-pay towards the procedure done in the office, that's where it picks, um, the APL picks up.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Got you. OK, no problem, that's what I wanted to know. um, OK, and I apologize who am I speaking with please?
[AGENT][NEUTRAL] It is [PII]. Would you like me to spell that for you?
[CUSTOMER][POSITIVE] Please, thank you.
[AGENT][NEUTRAL] You're welcome. It is spelled [PII] Last initial of [PII] and today's date will be used as the call reference.
[CUSTOMER][POSITIVE] [PII]. Thank you so very much. I appreciate your help and your time and you have a wonderful now so this it does.
[CUSTOMER][NEUTRAL] This policy does not come with a group number by any chance, does it?
[AGENT][NEUTRAL] Let me get that for you.
[CUSTOMER][POSITIVE] I appreciate that thank you.
[AGENT][NEUTRAL] You're welcome. The group number is 16497.
[CUSTOMER][NEUTRAL] 16. Mhm.
[CUSTOMER][NEUTRAL] 16497
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] I appreciate you thank you so very much you have a wonderful day, OK?
[AGENT][POSITIVE] You're welcome thank you for calling American Public Life, have a great day as well.
[CUSTOMER][NEUTRAL] Likewise, ma'am. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye.