AccountId: 011433970860
ContactId: bdcd657e-a312-4b51-a211-dfb2578d89e5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 381149 ms
Total Talk Time (AGENT): 98408 ms
Total Talk Time (CUSTOMER): 154881 ms
Interruptions: 4
Overall Sentiment: AGENT=1.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/bdcd657e-a312-4b51-a211-dfb2578d89e5_20241230T18:06_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] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Hi [PII], my name's [PII]. I'm calling from the Miami Hand Center.
[AGENT][POSITIVE] Yes, how may I help you?
[CUSTOMER][NEUTRAL] Hello. Hi, uh, OK, so I'm calling over a mutual, uh, patient that we have, [PII]. I can give you her date of birth.
[AGENT][NEUTRAL] Do you have the policy number?
[CUSTOMER][NEUTRAL] Um, yes.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] 1659502.
[AGENT][NEUTRAL] And may I have a callback number please?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Um, yes, it's gonna be [PII], and you can ask for [PII].
[CUSTOMER][NEUTRAL] OK, so you mean you're telling me that my.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Delay
[CUSTOMER][NEUTRAL] Several months.
[AGENT][NEUTRAL] And may I please have the date of birth?
[CUSTOMER][NEUTRAL] Yeah, um, [PII].
[CUSTOMER][NEUTRAL] So
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy you were calling in for benefits for this member?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, yes, I was actually calling you, um, to ask, um, a couple questions about how you guys do the, the coverage of their bills.
[AGENT][NEUTRAL] OK, so with this policy, this is a supplemental to their primary insurance.
[CUSTOMER][NEUTRAL] Who's in the rehab or the PC.
[AGENT][NEUTRAL] And it is based off of which benefit plan that they have. We go off of the deductible, co-insurance, or co-pay of the primary, and this policy is only for sickness and injury. It does not cover any type of preventative or wellness.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Good afternoon. Uh, my name is.
[CUSTOMER][NEUTRAL] OK, um, so when the patient spoke, when the patient's mother spoke to you earlier, she said that you guys cover $50.50 dollars.
[CUSTOMER][NEUTRAL] Is that correct?
[AGENT][NEUTRAL] Is this for an office visit, office setting, outpatient inpatient? Let me check that for you.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And can I have your name? I'm sorry.
[AGENT][NEUTRAL] It is [PII] that is spelled [PII] and today's date will be the call reference.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And do you have a reference number?
[AGENT][NEUTRAL] And it's
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] That's the call reference that's what I just gave you.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] They should call on December.
[AGENT][NEUTRAL] And is this for a specialist or a regular office visit?
[CUSTOMER][NEUTRAL] A specialist, the hand specialist.
[CUSTOMER][NEUTRAL] Today and we send a request.
[AGENT][POSITIVE] I'm pulling those benefits up for you now.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yes, but
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And verification of coverage does not guarantee the payment of the claim. For the office visit fee, the member has up to $50 per visit with a maximum of 4 visits per calendar year, and for a procedure that is rendered within an office, the member has up to $7900 per calendar year.
[CUSTOMER][NEUTRAL] And they
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Like.
[CUSTOMER][NEUTRAL] OK, so you said 50 per visit?
[AGENT][NEUTRAL] $50 per visit with 4 visits per calendar year.
[CUSTOMER][NEUTRAL] What is its calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, um, let's see if I need anything else, OK.
[CUSTOMER][NEUTRAL] Uh, just to confirm, you said 50 correct?
[AGENT][NEUTRAL] Yes, $50.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and um just give me one more second.
[CUSTOMER][POSITIVE] Uh, can I put you on hold for a brief second? OK, thank you so much.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you so much [PII].
[AGENT][NEUTRAL] Yes, is there anything else that I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] That is all thank you so much.
[AGENT][POSITIVE] Thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thank you.