AccountId: 011433970860
ContactId: f549a689-e37c-4303-9fc4-4c3c48fa2bff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 318519 ms
Total Talk Time (AGENT): 141630 ms
Total Talk Time (CUSTOMER): 82704 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/f549a689-e37c-4303-9fc4-4c3c48fa2bff_20250221T15:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I'm calling. I have a patient that's gonna have um a birth control device removed in our office on Monday and it's gonna be done by ultrasound guidance and I was wanting to get the benefits for that.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Sure, I could check those benefits for you. um, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] My name's [PII].
[AGENT][NEUTRAL] [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] I don't have the policy number. I have patient's name and date of birth.
[AGENT][NEUTRAL] OK, you don't have a social?
[CUSTOMER][NEUTRAL] We don't have one on file for her.
[AGENT][NEUTRAL] OK, OK, if you wouldn't mind uh spelling out the first and last name for me.
[CUSTOMER][NEUTRAL] OK, this is the first name, uh, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the last name is [PII]
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK. And then uh do you have the patient's date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect. OK, thank you for that. um, so I did find the policy before we go any further, would you like me to give you that policy number?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, it is 02584602.
[CUSTOMER][NEUTRAL] And that's American Public Life, isn't it?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and give me just a moment, let me get the policy pulled up. This is a limited indemnity medical plan and of course it is currently active. Did you need that effective date?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Alrighty, bear with me just a moment, let me get that policy pulled up and I will take a look at those coverages.
[CUSTOMER][NEUTRAL] And I have billing codes too. I don't know if that um.
[AGENT][NEUTRAL] Um, for this kind of policy, it's again uh limited, so some of them don't offer any benefits for office visits at all. So let me first, uh, just get that pulled up and we will take a look.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and of course I will let you know [PII] verification of coverage is not a guarantee of payment for claims.
[AGENT][NEUTRAL] So they have office visit benefits they've got um separate benefit for wellness um for regular office visit it would pay $75 max per visit and that's limited to 5 visits per calendar year.
[AGENT][NEUTRAL] I know we're a bit early in the year, but I can see if any of those have been used.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so she's not used any of the office visits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you need any of our billing information? do you have a, uh, mailing address, fax number, and a payer ID?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] What's the uh claims address, mailing address?
[AGENT][NEUTRAL] Yes, that is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK, and so as far as the ultrasound and the um the IUD removal, it won't pay anything on those two things just on the office.
[AGENT][NEUTRAL] No, so again this is extremely limited um policy so it's yeah it's just that flat benefit.
[CUSTOMER][NEUTRAL] OK, that's what I thought. Mhm.
[CUSTOMER][POSITIVE] OK all right well thank you so much for your time.
[AGENT][POSITIVE] You're welcome. Was there anything else I could help you with?
[CUSTOMER][POSITIVE] Uh, no, that's it, thank you.
[AGENT][POSITIVE] Alright, well thanks for calling APL East. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you bye bye.