AccountId: 011433970860
ContactId: e6593c0d-f556-405f-9bfb-4bf61978f8e7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229360 ms
Total Talk Time (AGENT): 103039 ms
Total Talk Time (CUSTOMER): 106763 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/e6593c0d-f556-405f-9bfb-4bf61978f8e7_20250501T18:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, good afternoon. Uh my name is [PII], uh which is spelled [PII] and I'm calling on behalf of our provider's office uh trying to get benefits for uh one of your members.
[AGENT][NEUTRAL] I can verify benefits. May I have a policy number?
[CUSTOMER][NEUTRAL] Yes, policy number, it's gonna be 02616203.
[AGENT][POSITIVE] Thank you. May I have a good callback number for you?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] [PII], thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yes, this is for patient um [PII] with date of birth, [PII].
[AGENT][NEUTRAL] Thank you for verifying that. This plan is effective for [PII] and it is active. And which benefit can I provide for you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK. Well, she's coming for the wellness exam, the annual uh Pap smear and laboratories, and I will need uh also benefits for um
[CUSTOMER][NEUTRAL] For PCP or specialist office visit?
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And lastly, I will be benefits for uh diagnostic X-rays and labs all done at, at the office.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so this plan is a hospital indemnity plan. It is a limited benefit plan, which means there's no co-pays. So for a physician's office visit, it allows $100 per day, max 4 days per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Diagnostic test benefit allows $200 per day, max 1 day per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let's see.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEGATIVE] Not showing any wellness.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I don't see any separate wellness.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, thank you.
[AGENT][NEUTRAL] OK, so everything will fall under that physician's office visit.
[AGENT][NEUTRAL] And then the diagnostic test falls under the 200 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May, OK, got it. And then, um, do you know how many visits are available for this patient, for the physician office visit?
[AGENT][NEGATIVE] No benefits have been applied for [PII].
[AGENT][NEUTRAL] So everything is still available.
[CUSTOMER][NEUTRAL] OK, 24.
[CUSTOMER][POSITIVE] Mhm. OK, perfect. And then, um, well, no, I think that's pretty much what I needed to, to know at this moment. Thank you so much. May I, uh, can you spell your, the, your name and your last initial, please?
[AGENT][NEUTRAL] Yes, it's [PII] Last initial is [PII]
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh. And uh are you able to provide a reference number or your name and your in today's state?
[AGENT][NEUTRAL] The reference will be my name along with today's date. [PII], is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh, no, not really. Well, thank you so much for this information, [PII] and have a nice day. Thank you.
[AGENT][POSITIVE] You're so welcome and thank you for calling American Public Life, [PII]. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] You as well bye bye.