AccountId: 011433970860
ContactId: a6a5db02-023e-4c36-a3b1-0ee9ea053356
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172720 ms
Total Talk Time (AGENT): 71937 ms
Total Talk Time (CUSTOMER): 73469 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/a6a5db02-023e-4c36-a3b1-0ee9ea053356_20250623T20:37_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling to verify um coverage of one of your members for um medical gap insurance.
[AGENT][NEUTRAL] I can verify eligibility. May I have your name and the policy number?
[CUSTOMER][NEUTRAL] Uh-huh. My name is [PII]. The policy I'm calling about is 02538048ML8.
[AGENT][POSITIVE] Thank you. May I have a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] My name is [PII]. Her date of birth is um [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. This plan is effective [PII] and it is active.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What other
[CUSTOMER][NEUTRAL] Does she have, cause she's having an outpatient surgery, so does, do you cover any of the deductible or coinsurance that might apply to those procedures?
[AGENT][NEUTRAL] This plan will pick up the co-pays to co-insurance and or deductibles up to the benefit amount. So please be advised that verification of coverage does not guarantee the payment of a claim. Outpatient per calendar day allows $250.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So we'll pick up up to 250 per day.
[CUSTOMER][NEUTRAL] That's for, that's it. That's all she, that's all that's.
[AGENT][NEUTRAL] Yes, ma'am. 250 per day.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, but if she's not being hospitalized, it's not inpatient. It's an outpatient surgery. It's a one-time procedure. It's subject to her deductible, $5000 deductible. So you're saying out of the $5000 deductible that she's responsible for, you'll pay $250?
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, ma'am. That is correct.
[CUSTOMER][NEUTRAL] Wow, I've never heard of anything that low.
[AGENT][NEUTRAL] Yes ma'am. These plans have different benefit max. Her inpatient will allow 3000, but her outpatient is a per calendar day.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, and can I have a reference number for this call?
[AGENT][NEUTRAL] Yes, it will be my name, which is [PII] Last initial is [PII] along with today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, all right, all right, thank you so much. I appreciate it.
[AGENT][POSITIVE] You're so welcome and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] You too bye bye.