AccountId: 011433970860
ContactId: ae7e4dd5-8272-43ab-97f6-831b8584b4fe
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184380 ms
Total Talk Time (AGENT): 85745 ms
Total Talk Time (CUSTOMER): 69857 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/ae7e4dd5-8272-43ab-97f6-831b8584b4fe_20250408T19:11_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, good afternoon. My name is [PII]. I'm calling from [PII]. I think is to verify some benefits for a member, please.
[AGENT][NEUTRAL] May I please have a callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the policy number.
[CUSTOMER][NEUTRAL] 02595723 ML 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And thank you [PII] for verifying the policy you're calling in for benefits. Is there a specific benefit that you're calling in for?
[CUSTOMER][NEUTRAL] Yeah, she's having an allergy testing done in the specialist's office and we would like to know if this is gonna be covered, please.
[AGENT][NEUTRAL] She's having an allergy test. 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 the payment of the claim. For this member, they don't have the office visit fee benefit rider, but for the procedure rendered within an office setting, the member does have up to $1000 per calendar year, 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] OK, so it's only for senior injury. No prey and awareness.
[AGENT][NEUTRAL] Or wellness. Correct.
[CUSTOMER][NEUTRAL] OK, so that's my, what I'm confused. Um, she, they're, we're doing the allergy testing. This is because she has um runny nose and nasal congestion.
[CUSTOMER][NEUTRAL] This, it's depending on the diagnosis, how you would decide if this is considered sickness or injury, right?
[AGENT][NEUTRAL] It's based off of how it's billed. So if it's not for preventative or wellness and it is for sickness and injury, then it's considered under that $1000 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, OK, now I get you. OK, perfect, thank you so much and you say your name is?
[AGENT][NEUTRAL] It is [PII]. Would you like me to spell that for you?
[CUSTOMER][NEUTRAL] Please.
[AGENT][NEUTRAL] It is spelled [PII] last [PII] [PII] and today's date will be used as the call reference.
[CUSTOMER][POSITIVE] OK, thank you so much OK and have a nice day.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day as well, [PII].