AccountId: 011433970860
ContactId: f36ade3b-a625-4ee5-af6f-dea044d2c000
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 267720 ms
Total Talk Time (AGENT): 112449 ms
Total Talk Time (CUSTOMER): 89219 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/f36ade3b-a625-4ee5-af6f-dea044d2c000_20250311T12:51_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Good morning. I'm here to verify benefits please.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the benefits. May I have your name and a good contact number?
[CUSTOMER][NEUTRAL] My name is [PII] and I'm calling from the pediatric Center of Stone Mountain.
[AGENT][NEUTRAL] Thank you, and [PII], may I have a good contact number in case we're disconnected and the member's policy number?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] 7706568338
[CUSTOMER][NEUTRAL] No, just a sec, I'm gonna give you this one. Sorry about that 1 [PII].
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK, and the policy number?
[CUSTOMER][NEUTRAL] I'm giving you my personal number.
[CUSTOMER][NEUTRAL] The the policy number is 022-06104.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] OK, it's um [PII], um, [PII].
[CUSTOMER][NEUTRAL] [PII] yeah mhm.
[AGENT][POSITIVE] Thank you for
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Are you there?
[AGENT][NEUTRAL] Like, yes, I'm asking what kind of benefits did you want to go over, like, is she in hospital, is this outpatient? What did you want me to look for?
[CUSTOMER][NEUTRAL] Medical in the front office office office visit.
[AGENT][NEUTRAL] It's an office visit? OK.
[CUSTOMER][NEUTRAL] Yeah, it's the office well visit.
[AGENT][NEUTRAL] OK, so for this policy, the policy will pay up to $75 per visit with a max of 6 visits per calendar year. Did you want me to see if any of the 6 office visits have been used?
[CUSTOMER][NEUTRAL] Yeah, $75 they have to pay at each sick visit.
[AGENT][NEUTRAL] No, no, that's how much the policy would pay towards their physician office visit, $75.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Oh, so what about the web visit?
[AGENT][NEUTRAL] No matter what's done at the visit, it's, it's just $75 that will be applied.
[AGENT][NEUTRAL] Or that could be a pot.
[CUSTOMER][NEUTRAL] Oh, so they have to pay the remainder?
[CUSTOMER][NEUTRAL] So, so they would have to pay the remainder of visit?
[AGENT][NEUTRAL] Um, we don't determine patient responsibility. If they have no other insurance though, you may have to bill to them or, or whatever your, your, um, next steps are with an outstanding balance.
[CUSTOMER][NEUTRAL] Yeah, that's the only insurance she has is this, this insurance that I'm calling, that's the only insurance they have.
[CUSTOMER][NEUTRAL] So the child is covered under that plan?
[AGENT][NEUTRAL] I mean, yes, we have the physician office visit uh benefits, the 6 at $75 per year.
[CUSTOMER][NEUTRAL] OK, and um when was the effective date?
[AGENT][NEUTRAL] Hold on one moment. Policy has been effective since [PII].
[CUSTOMER][NEUTRAL] And do you, do you have a reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] Your first name is?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And have you seen um [PII]'s name on that plan?
[AGENT][NEUTRAL] Yes, she's she's on the, she's a covered member.
[CUSTOMER][NEUTRAL] And um is it just um this insurance is just American Public Life Insurance company that's the name of it?
[AGENT][NEUTRAL] The name of the company, yes, is American Public Life. The policy is a hospital indemnity policy.
[CUSTOMER][NEUTRAL] And it's APL.
[AGENT][NEUTRAL] Yes, American Public Life or APL is the name of the company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] That's all.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome, Ms. [PII]. Well, thank you so much for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.