AccountId: 011433970860
ContactId: f2a36aa9-6b6d-45ae-8599-cb065953a97d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 244220 ms
Total Talk Time (AGENT): 99547 ms
Total Talk Time (CUSTOMER): 101136 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/f2a36aa9-6b6d-45ae-8599-cb065953a97d_20250506T15:40_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 [PII]. Good good. I said, good afternoon. It's not afternoon yet still it's [PII] not afternoon yet. Um, my name is [PII]. We're the provider. I'm calling for the patient, um, eligibility and benefits, please.
[AGENT][NEUTRAL] OK, may I please have a callback number?
[CUSTOMER][NEUTRAL] OK. [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] OK, policy number is 02581319 MLA.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII] [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy. You're calling in for eligibility and benefits. Is there a specific benefit that you're calling in for?
[CUSTOMER][NEUTRAL] Yes, um, so does she have outpatient urgent care coverage?
[AGENT][NEUTRAL] Let me pull that up for you.
[AGENT][NEUTRAL] And for this member you're calling in for urgent care, verification of coverage does not guarantee the payment of the claim.
[AGENT][NEUTRAL] For this member, it is currently active with the effective date of [PII]. For outpatient, the member has up to $3000 per calendar day that will go towards the primary insurance deductible, co-insurance, or co-pay. This policy is for sickness and injury only. It does not cover any preventative or wellness. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Yes, sorry. So, I'm sorry. So, I'm sorry, it does not cover outpatient urgent care?
[AGENT][NEUTRAL] It does not cover preventative or wellness.
[CUSTOMER][NEUTRAL] Oh, OK, so it is, OK, so that's fine. So it does, so it does cover outpatient then, right?
[AGENT][NEUTRAL] Yes, as long as it's for sickness and injury.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Sickness meaning like, what do you mean?
[AGENT][NEUTRAL] If you're sick or if you have an injury, it's for sickness. I'm just saying that we, we'll cover, huh? Go ahead.
[CUSTOMER][NEUTRAL] Let's, let's see what they can. OK, he, he fell, he fell, so, OK, so he, he fell, so he's fine.
[AGENT][NEUTRAL] Yes, we just don't.
[CUSTOMER][NEUTRAL] Because it's for an injury, right? OK.
[AGENT][NEUTRAL] Yes, we just don't cover preventative or wellness for this policy.
[CUSTOMER][POSITIVE] OK perfect so let me go ahead and make a note.
[CUSTOMER][NEUTRAL] OK, is the group name gonna be Hayman Americas Inc?
[AGENT][NEUTRAL] Let me check that for you.
[CUSTOMER][POSITIVE] Thanks.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, I guess it's [PII] or [PII], American in yes.
[CUSTOMER][NEUTRAL] however you say it, I don't know.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK perfect what is the group number gonna be Tarika?
[AGENT][NEUTRAL] It is 80069.
[CUSTOMER][NEUTRAL] 80069. OK, perfect. 88 yeah 80069 and he's the subscriber, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] I believe it's a, is this a female?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, perfect. OK.
[CUSTOMER][NEUTRAL] OK, and your name is [PII], how do you spell your name?
[AGENT][NEUTRAL] Yes, it is spelled [PII] with the last initial of [PII] and today's date as the call reference.
[CUSTOMER][NEUTRAL] Thank you. And do you have a, oh yeah, I, I do, I did know that. Sorry, I'm not thinking.
[AGENT][POSITIVE] Oh, that's no problem.
[CUSTOMER][POSITIVE] All right perfect thank you for everything. I hope you have a great afternoon.
[AGENT][POSITIVE] You're welcome and thank you so much for calling American Public Life. You have a great afternoon as well.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] All right.