AccountId: 011433970860
ContactId: b24dac8e-5efc-4aac-a0e1-74e2f423890f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 234479 ms
Total Talk Time (AGENT): 95252 ms
Total Talk Time (CUSTOMER): 104537 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/b24dac8e-5efc-4aac-a0e1-74e2f423890f_20250428T18:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, good afternoon. This is [PII] from Florida Dermatology specialist. We just want to check for benefits and eligibility for one of our patients.
[AGENT][NEUTRAL] OK, I could check eligibility benefits for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] It's right. It's spelled as [PII].
[AGENT][NEUTRAL] OK, and then right, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, I do have it. Policy number is 01618198ML8.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] This is for [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we're gonna need to look at inpatient or outpatient benefits, right?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Outpatient services will be done in the office?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. That outpatient benefit is $3000 max per calendar year. and office treatment or office visits are not going to be covered under this policy unless it is, uh, specifically for cancer treatment.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Office visit is not covered unless it's cancer treatment, OK?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] How, how about for the 3000 coverage? Does it include like biopsy, surgeries?
[AGENT][POSITIVE] Yes, absolutely.
[CUSTOMER][NEUTRAL] All right, again.
[CUSTOMER][NEUTRAL] So this is is uh.
[CUSTOMER][NEUTRAL] Alright, OK, thank you. So again, just to confirm, um, this plan is active. Can I have the full plan name for this one or is it just APL supplement plan?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, it's American Public Life. This is our secondary medical policy.
[CUSTOMER][NEUTRAL] Secondary medical policy. OK. Thank you.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yeah, was there anything else I can help you with [PII]?
[CUSTOMER][NEUTRAL] Um, just wanna ask as well for future purposes, we actually require like referral or authorization for like surgeries?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This policy does not uh require authorization, um, as long as major medical is willing to pay this policy can.
[CUSTOMER][NEUTRAL] All right. OK, thank you. Again, maximum coverage is 3000, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Per calendar year, yes.
[CUSTOMER][NEUTRAL] That's for the whole, per, per year. OK, the whole, for the whole year.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, I think I'm good to go with the number. I just need a call reference number and can I have your name again, please? Can you spell that out for me?
[AGENT][NEUTRAL] Sure, yes, so the reference number would just be my first name, last initial, and today's date. So my name is spelled [PII]
[CUSTOMER][POSITIVE] Mhm thank you so much, [PII].
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You as well thank you so much.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Goodbye.