AccountId: 011433970860
ContactId: defc243f-fc38-4586-9c98-2e4f6b4e400d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 256579 ms
Total Talk Time (AGENT): 102895 ms
Total Talk Time (CUSTOMER): 66044 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/defc243f-fc38-4586-9c98-2e4f6b4e400d_20250522T14:34_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, um, [PII], my name is [PII], and I'm calling from the Will County Community Health Center, and I need to verify a patient's benefits.
[AGENT][NEUTRAL] OK, may I please have a callback number?
[CUSTOMER][NEUTRAL] My number is [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] Policy number is 02560704.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy. You're calling in for benefits. Is there a specific benefit you're calling in for?
[CUSTOMER][NEUTRAL] For a, uh, hold on for a doctor's visit.
[AGENT][NEUTRAL] OK, office visit, I'll pull that up for you.
[CUSTOMER][NEUTRAL] She's coming in for, yeah, for doctor. She's coming in for a, I'll tell you in two shakes of a cocktail. Hold on a sec. She came in. Let's see, I think that she came in. She was in yesterday. She came in for a gynecological visit.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, if it's for wellness or preventative, you would have to contact IMA first cause they do handle the wellness and preventative. And then I can also still give you the benefits for us as well.
[CUSTOMER][NEUTRAL] Did you say RMA or RNA?
[AGENT][NEUTRAL] I M A
[CUSTOMER][NEUTRAL] Oh, I.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And I can get you that information for them.
[AGENT][NEUTRAL] And in regards to the member's office visit, verification of coverage does not guarantee the payment of the claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For the office visit.
[AGENT][NEUTRAL] The member does have up to $75 per day with a maximum of 6 days per calendar year. If there's anything that is left over after that $75 is paid, that is considered patients responsibility. This policy is an indemnity policy, which is a limited benefit.
[CUSTOMER][NEUTRAL] So it's because it's an indemnity policy.
[CUSTOMER][NEUTRAL] So you guys would pay just $75 and then they're responsible for the balance.
[AGENT][NEUTRAL] Yes, but that's why you need to check with the um IMA and they can verify the benefits as well and they'll probably try to transfer you over, but you can go ahead and let them know that you had already spoken with [PII] but you're needing to verify the benefits and let me get that information for you.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Check with the other people.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So to contact IMA that would be [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you so much. I appreciate your help.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life, [PII]. Have a great day.
[CUSTOMER][NEUTRAL] Alright bye bye.