AccountId: 011433970860
ContactId: c9f3b84b-bfff-43d6-a51c-1bfd886e6588
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160059 ms
Total Talk Time (AGENT): 75757 ms
Total Talk Time (CUSTOMER): 72733 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/c9f3b84b-bfff-43d6-a51c-1bfd886e6588_20250123T19:31_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, yes, my name is [PII] I'm looking to verify eligibility and benefits for a member's secondary policy.
[AGENT][NEUTRAL] OK, may I please have a callback number and then the policy number?
[CUSTOMER][NEUTRAL] Yes, so my callback number is [PII], and the policy number that I have here for the member is 021-70589L8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, so I have here [PII] with the date of birth of [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy. You're calling in for eligibility and benefits for this member?
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][POSITIVE] That is correct, yes.
[AGENT][NEUTRAL] And is there a specific, go ahead.
[CUSTOMER][NEUTRAL] And I'm sorry, I
[CUSTOMER][NEUTRAL] Yeah, I just wanted to ask if I could have uh the spelling of your name real quick.
[AGENT][NEUTRAL] Yes, the spelling is [PII] and today's date will be used as the call reference.
[CUSTOMER][POSITIVE] Excellent thank you so much yes sorry about that.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And for that benefit, could you verify which benefit that you would like for me to review?
[CUSTOMER][NEUTRAL] Yes, so, uh, they are coming in for an outpatient ambulatory surgical center, uh, or rather procedure at an outpatient ambulatory surgical center, so I'm looking for the coverage basis of their secondary policy.
[AGENT][NEUTRAL] OK, thank you, and verification of coverage does not guarantee the payment of the claim. For this policy, it is currently active. The effective date is for [PII]. For outpatient, the member has up to $6600 per calendar year that will go towards the primary insurance deductible, co-insurance, or co-pay.
[CUSTOMER][NEUTRAL] Mhm.
[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] Um, yes, just one more detail as far as the coverage basis goes, so $6600 could you verify if anything has been met towards that amount?
[AGENT][NEGATIVE] As of right now, the member has not used any of their benefits.
[CUSTOMER][POSITIVE] Understood. I'll make a note of that here and um yeah, should be wrapping up. I already got the reference number, so with that being said, I really do appreciate your time and taking this call and I hope you have a great day.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day as well.
[CUSTOMER][NEUTRAL] Alright bye bye now.
[AGENT][NEUTRAL] Bye