AccountId: 011433970860
ContactId: b080365d-17b0-4f07-a958-f577026b8d47
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184580 ms
Total Talk Time (AGENT): 91084 ms
Total Talk Time (CUSTOMER): 74713 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/b080365d-17b0-4f07-a958-f577026b8d47_20250313T13:42_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. My name is [PII]. I'm calling um to verify a specific mental health benefits for a member today.
[AGENT][NEUTRAL] OK, I can help you with that, [PII]. Could I get a callback number?
[CUSTOMER][NEUTRAL] Um, yes, [PII].
[AGENT][NEUTRAL] Thank you. And what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] Um, 023343-778.
[AGENT][NEUTRAL] The patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII], [PII].
[AGENT][POSITIVE] OK, thank you so much for verifying the policy and you did say you were calling for mental health benefits.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, please be advised verifying benefits is not guaranteed payment. Her policy with us has been effective since [PII]. It is still active. I show for mental health, that would be covered under the outpatient benefit paying up to $3000 a calendar year. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK, so it's um.
[CUSTOMER][NEUTRAL] It's telehealth covered for PHP and IOP levels of care?
[AGENT][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Oh, OK, so telehealth virtual visits for PHP and IOP is covered on that. OK, and then there's, so there's no co-pay or co-insurance.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] No, this pays secondary to her major medical, uh, helping pick up expenses applied to deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] Expensive.
[CUSTOMER][NEUTRAL] OK, got it. And then is an authorization required for um PHP and ILP?
[AGENT][NEUTRAL] Pre pre-authorization is not required.
[CUSTOMER][NEUTRAL] OK. And are there any visit limits or state restrictions?
[AGENT][NEUTRAL] No, it is the dollar limit of $3000.
[CUSTOMER][NEUTRAL] OK, and then what's the claims address and payer ID just to notate on this form.
[AGENT][NEUTRAL] No problem. Uh, the payer ID is 60801.
[AGENT][NEUTRAL] The um.
[AGENT][NEUTRAL] What did, uh, the claim's mailing address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, and does this run on a calendar year?
[AGENT][NEUTRAL] It is the calendar year maximum, yes.
[CUSTOMER][POSITIVE] OK, perfect. I'm all set um if I can just get your name and a call reference.
[AGENT][NEUTRAL] To reference the call, you will use my name [PII] and today's date.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome you have a wonderful day and thank you for calling APO.
[CUSTOMER][NEUTRAL] You too. Bye