AccountId: 011433970860
ContactId: f3cabb1c-755a-46bf-86bf-f1856c9e4848
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 200839 ms
Total Talk Time (AGENT): 88330 ms
Total Talk Time (CUSTOMER): 84262 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/f3cabb1c-755a-46bf-86bf-f1856c9e4848_20250320T17:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is.
[CUSTOMER][NEUTRAL] Hi, you said [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], hi, my name is [PII]. I'm calling from a provider's office.
[CUSTOMER][NEUTRAL] And I needed to um just confirm the coverage um a patient has.
[AGENT][NEUTRAL] I can verify eligibility. May I have the policy number?
[CUSTOMER][NEUTRAL] Of course it's 1393.
[CUSTOMER][NEUTRAL] 263
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, the number 8.
[AGENT][POSITIVE] Thank you. May I have a good callback number for you?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] This is for [PII] [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. This plan is effective [PII] and it is active.
[CUSTOMER][NEUTRAL] OK, and for outpatient, um, specialist office, do you guys pick up whatever the second, uh, the primary doesn't.
[CUSTOMER][NEUTRAL] Like her deductible co-payments and co-insurance, what is it that you guys cover for?
[AGENT][NEUTRAL] Correct. Please be advised that verification of coverage does not guarantee the payment of a claim. This plan will pick up the copays to co-insurance and or deductibles behind the primary. This policy has the office treatment benefit, but not the actual office visit benefit.
[CUSTOMER][NEUTRAL] OK, so she has a copayment for the primary, she, she would be responsible for it.
[AGENT][NEGATIVE] This plan, if it's for the office visit, this plan will not pick up.
[CUSTOMER][NEUTRAL] Is that what you're saying?
[AGENT][NEUTRAL] If it's for treatment.
[CUSTOMER][NEUTRAL] OK, so, but
[CUSTOMER][NEUTRAL] So any treatment done is covered, like X-rays, ultrasound, injections. Got you.
[AGENT][POSITIVE] Correct. Correct.
[AGENT][NEUTRAL] For any treatment.
[CUSTOMER][NEUTRAL] All right and.
[AGENT][NEUTRAL] It's allowed under the outpatient calendar year benefit amount of $7000.
[CUSTOMER][NEUTRAL] 7000.
[CUSTOMER][NEUTRAL] Alright, and we filed the claims with the same ID that I gave you, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And it's to American Public Life [PII].
[AGENT][NEUTRAL] No, ma'am. It's [PII].
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] And that's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm uh mm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I think that was all my questions and um [PII], do we have a reference number for the call?
[AGENT][NEUTRAL] Yes, it will be my name which is [PII] Last initial is [PII] along with today's date. [PII] is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that was it. Thank you very much.
[AGENT][POSITIVE] Thank you for calling American Public Life. Ole. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] You too bye bye.