AccountId: 011433970860
ContactId: c8354cb0-fcf6-409d-8818-26fc525e56d4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 179970 ms
Total Talk Time (AGENT): 68589 ms
Total Talk Time (CUSTOMER): 93362 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/c8354cb0-fcf6-409d-8818-26fc525e56d4_20250103T19:36_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. Yeah, I'm calling to find out um if um my um the IPL if, if it covers um machines like uh CPAP, like uh a machine for sleep apnea.
[AGENT][NEUTRAL] May I have your policy number and I'll pull up your benefits.
[CUSTOMER][NEUTRAL] Sure. Uh, the policy number, um,
[CUSTOMER][NEUTRAL] I have 2 numbers, uh, in the hospital benefit or outpatient benefit.
[AGENT][NEUTRAL] Outpatient benefit, please.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK, outpatient is 0130.
[CUSTOMER][NEUTRAL] 673-6 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] May I have your first and last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Can you verify your date of birth, your mailing address, and your email, please?
[CUSTOMER][NEUTRAL] Um [PII], mailing address is [PII]. My email, I think it's uh because I have to um [PII].
[AGENT][POSITIVE] Thank you for verifying that information. May I have a good callback number for you?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you. And under this policy, please be advised that verification of coverage does not guarantee the payment of a claim. There are no benefits for DME or DME supplies.
[CUSTOMER][NEUTRAL] For the machine
[AGENT][POSITIVE] Correct.
[AGENT][NEGATIVE] So no DME is covered under this policy.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Right, OK, um, let me ask you something else. Is the, uh, um, co-pay, um, the co-payments for um the hospital for like doctor visit at the hospital, is it covered under my policy?
[AGENT][NEUTRAL] So for outpatient calendar year, you are allowed 5000 per calendar year, but for a doctor's office visit in the hospital,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] It would not cover that.
[AGENT][NEUTRAL] The doctor would have to bill according to the place of service.
[CUSTOMER][NEUTRAL] Um, so, right, but what, what if the place of service it's at the actual hospital?
[AGENT][NEUTRAL] Yes, that will fall into your outpatient and it will pick up your co-pays, your co-insurance, and our deductibles.
[CUSTOMER][POSITIVE] OK. All right. OK. Well, perfect. Thank you so much.
[AGENT][POSITIVE] You're so welcome. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] Um, no, that was it. Thank you.
[AGENT][POSITIVE] [PII], thank you so much for calling American Public Life. Have a great day. Bye bye.
[CUSTOMER][NEUTRAL] You too.