AccountId: 011433970860
ContactId: f7c17cfa-827f-4bba-8590-edf70889403e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 464290 ms
Total Talk Time (AGENT): 95262 ms
Total Talk Time (CUSTOMER): 129149 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/f7c17cfa-827f-4bba-8590-edf70889403e_20250530T20:07_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. This is [PII] calling from the Palman Pain Associates LLC, Doctor [PII]'s office. How are you doing today?
[AGENT][NEUTRAL] No.
[AGENT][POSITIVE] Good, how are you?
[CUSTOMER][POSITIVE] I'm good, thanks for asking. Actually, [PII], I'm calling regarding the eligibility and verification for one of our patients. So can you please help me with that?
[AGENT][NEUTRAL] Yes, sir. I can help you with that. Uh, could I get the spelling of your name, please?
[CUSTOMER][NEUTRAL] It is [PII]
[AGENT][NEUTRAL] Oh, [PII]. OK. And [PII], if I could get a callback number for you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, you say you're calling for eligibility and verification today?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Policy number
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have benefit certificate number here as 01997209 M as in Mary L as in Lima 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient first name [PII]. Last name [PII].
[AGENT][NEUTRAL] And her date of birth, please.
[CUSTOMER][NEUTRAL] Uh, let me check the date of birth, just a second.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying the account. And so I show that this policy is effective. It's been effective since [PII]. Are you uh calling for a specific uh benefits for a service?
[CUSTOMER][NEUTRAL] Uh, yeah, I'm calling for the benefits of pain management.
[AGENT][NEUTRAL] Is this done in a physician's office?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, please be advised verifying benefits does not guarantee payment.
[AGENT][NEUTRAL] I show for physician benefits.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The policy would not cover the physician office visit. If other treatment is rendered, while in the office, the policy will pay up to $250 a day. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK, and can you please confirm if the
[CUSTOMER][NEUTRAL] Um, you know, professional visit is covered under the policy or not.
[AGENT][NEUTRAL] If they what?
[CUSTOMER][NEUTRAL] Professional visit?
[AGENT][NEUTRAL] The office visit is not covered.
[CUSTOMER][NEUTRAL] Not covered, OK. Uh, any kind of injections, pain management injection are covered?
[AGENT][NEUTRAL] Oh my [PII]
[AGENT][NEUTRAL] As I stated, other treatment would be covered up to $250 a day.
[CUSTOMER][NEUTRAL] OK, and what was the timely filing to file a claim to the insurance?
[AGENT][NEGATIVE] There is no timely filing for this policy.
[CUSTOMER][NEUTRAL] OK, perfect. And the claim should be submitted to [PII], right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] OK, perfect, thank you so much, [PII]. And is there any call reference number for our call?
[AGENT][NEUTRAL] To reference our call, you will use my name, [PII] and today's date.
[AGENT][NEUTRAL] And is there anything else I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, no, thank you so much, [PII], and enjoy the rest of the day. Bye bye.
[AGENT][POSITIVE] You're welcome you have a wonderful weekend. Thank you for calling APL bye bye.
[CUSTOMER][NEUTRAL] Mhm mhm.
[CUSTOMER][NEUTRAL] Yeah, uh, co-sign missing file all are done.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] I didn't open that.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah