AccountId: 011433970860
ContactId: d25df0aa-a24f-4d3c-841f-3d4de0e192ca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217350 ms
Total Talk Time (AGENT): 97011 ms
Total Talk Time (CUSTOMER): 145801 ms
Interruptions: 9
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/d25df0aa-a24f-4d3c-841f-3d4de0e192ca_20250505T17:21_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I need to check the eligibility, the benefits, and the authorization requirements for outpatient surgery, please.
[AGENT][NEUTRAL] I can verify benefits and eligibility. May I have your name and the policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] My name is [PII]. The number is 02595732.
[AGENT][NEUTRAL] [PII], may I have a good callback number for you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Because she's not
[CUSTOMER][NEUTRAL] Uh, yes ma'am. OK, [PII], [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. This policy is effective [PII] and it is active. Prior op is not required for these policies. And which benefit can I provide for you?
[CUSTOMER][NEUTRAL] so.
[CUSTOMER][NEUTRAL] policy.
[CUSTOMER][NEUTRAL] Is not required.
[CUSTOMER][NEUTRAL] Are they?
[CUSTOMER][NEUTRAL] Um, I need to see how you guys would pay after Blue Cross Blue Shield as the primary.
[AGENT][NEUTRAL] Would it be for inpatient, outpatient, office visit?
[CUSTOMER][NEUTRAL] inpatient outpatient.
[CUSTOMER][NEUTRAL] Outpatient?
[AGENT][NEUTRAL] Outpatient allows $6900. There is also a $1000 deductible.
[CUSTOMER][NEUTRAL] Outpatient about.
[CUSTOMER][NEUTRAL] $6900 and it's also $1000.
[CUSTOMER][NEUTRAL] Has anything been met towards that addressable?
[AGENT][NEUTRAL] One moment, I'll get this pulled up.
[CUSTOMER][NEUTRAL] You
[AGENT][NEGATIVE] No benefits have been applied for 2025.
[CUSTOMER][NEUTRAL] OK, so she's got $1000. Does she have coinsurance?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Does she have coinsurance?
[AGENT][NEUTRAL] This plan will pick up her co-pays for co-insurance and or deductibles.
[CUSTOMER][POSITIVE] Alright, I'm sorry because you.
[AGENT][NEUTRAL] But she only has
[AGENT][NEUTRAL] She only has an outpatient deductible on this policy.
[CUSTOMER][NEUTRAL] She only has the outpatient deductible on the.
[CUSTOMER][NEUTRAL] OK, so she's gonna have to pay Blue Cross Blue Shield whatever they have and the sales knowledge address well for you guys as well.
[AGENT][NEUTRAL] Yes, this is Blue Cross applies 1000, this policy also applies 1000 before it starts paying out the benefits for outpatient.
[CUSTOMER][NEUTRAL] Yes, this is Blue Cross applies 1000, this policy also applies 1000 before it starts paying out the benefits.
[CUSTOMER][NEUTRAL] OK, and you said you have a $6900 limit?
[AGENT][NEUTRAL] Yes, 6900 will be her outpatient.
[CUSTOMER][NEUTRAL] Yeah, 6900 will be her outpatient.
[CUSTOMER][NEUTRAL] OK, and this is not a commercial plan, correct? I mean not a Medicare plan?
[AGENT][NEUTRAL] This is medical through her employer.
[AGENT][NEUTRAL] Or her husband's employer.
[CUSTOMER][NEUTRAL] OK, one second.
[CUSTOMER][NEUTRAL] Can I get your name please?
[AGENT][NEUTRAL] It's [PII] Last initial is [PII] along with today's date. [PII], is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Mo
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Last initial is [PII] along with today.
[CUSTOMER][NEUTRAL] [PII], is there
[CUSTOMER][POSITIVE] No ma'am, that was all thank you so much.
[AGENT][POSITIVE] You're so welcome and thank you for calling American Public Life, [PII]. Have a great day. Bye-bye.
[CUSTOMER][POSITIVE] Welcome, thank you and have a great day bye bye.