AccountId: 011433970860
ContactId: ae1de36f-887d-43a0-9324-123c6ee36b78
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223240 ms
Total Talk Time (AGENT): 94850 ms
Total Talk Time (CUSTOMER): 68837 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/ae1de36f-887d-43a0-9324-123c6ee36b78_20250313T15:52_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, yes, I'm calling to verify if this covers office visits for a patient.
[AGENT][NEUTRAL] May I have your name and a callback number?
[CUSTOMER][NEUTRAL] My name is [PII]. Callback number is area code [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] Uh, let me go back.
[CUSTOMER][NEUTRAL] Policy number is 01813090.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Last name [PII]. Date of birth is going to be.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] You're calling in for office visit benefits?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm pulling that information up for you now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And verification of coverage does not guarantee the payment of the claim. For the office visit fee, the member does not have that benefit, but for the procedure rendered within an office setting, the member has up to $4000 per calendar year. That will go towards the office procedure benefits.
[AGENT][NEUTRAL] Of the primary's deductible, coinsurance, or co-pay.
[AGENT][NEUTRAL] This policy is for sickness and injury only, it would not cover any preventative or wellness. Is there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Um, yes. When you say office procedure, is that like injections, X-rays?
[AGENT][NEUTRAL] Anything other than the office visit fee.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. May I please have a reference number?
[AGENT][NEUTRAL] Yes, the reference number will be my first name [PII], last initial of [PII] and today's date.
[CUSTOMER][POSITIVE] OK, awesome. Thank you so much.
[AGENT][POSITIVE] You're welcome. Thank you for, yes, yes.
[CUSTOMER][NEUTRAL] I'm sorry, one more question, one more, one more question. Um, is there a particular EDI number that we submit electronic claims to?
[AGENT][NEUTRAL] You're needing the electronic payer ID?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] For the electronic payer ID that is 60.
[AGENT][NEUTRAL] 801.
[AGENT][NEUTRAL] Now you do have the option to submit it via fax, mail, or our secured portal as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, um.
[CUSTOMER][NEUTRAL] Can I have the mailing address just in case?
[AGENT][NEUTRAL] Yes, the mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I'm sorry, you said 731-24.
[AGENT][NEUTRAL] 8950.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. Thank you so much.
[AGENT][POSITIVE] You're welcome thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you.