AccountId: 011433970860
ContactId: fac66cd5-a739-474e-b479-5b6e6e0e9882
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251800 ms
Total Talk Time (AGENT): 79570 ms
Total Talk Time (CUSTOMER): 70250 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/fac66cd5-a739-474e-b479-5b6e6e0e9882_20250331T17:57_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] Good afternoon, [PII]. My name is [PII]. I'm calling from Baptist Outpatient Services.
[AGENT][NEUTRAL] How may I assist you?
[CUSTOMER][NEUTRAL] Um, yes, I need the information eligibility and benefits for a patient who has gap insurance with you guys.
[AGENT][NEUTRAL] May I please have a callback number and then the policy number?
[CUSTOMER][NEUTRAL] Yeah, callback number is [PII] and whenever you're ready for that policy number.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] All right. Policy number is 0250.
[CUSTOMER][NEUTRAL] 0277.
[CUSTOMER][NEUTRAL] And that should be for [PII].
[AGENT][NEUTRAL] Date of birth, please.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And you're calling in for eligibility and benefits, is there a specific benefit you're calling in for?
[CUSTOMER][NEUTRAL] Um, no, it's just to see what her outpatient max amount is and what is remaining from it.
[AGENT][NEUTRAL] OK, I'm pulling that information up for you now.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And for the eligibility, it does show that the policy is currently active with the effective date of [PII] and I am pulling that benefit up for you now.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And verification of coverage does not guarantee the payment of the claim. This member does have up to $5000 per calendar year that will go towards the primary insurance deductible, co-insurance, or co-pay. This policy is for sickness and injury only. It would not cover any preventative or wellness.
[AGENT][NEUTRAL] And also for the cumulative.
[AGENT][NEUTRAL] For the year of [PII], it is showing that the member has not used any of their benefits.
[CUSTOMER][NEUTRAL] OK, perfect. Um, so just to verify that $5000 is your max out of pock I mean out of like max amount for their gap insurance and they haven't met anything this year.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And is that for outpatient?
[AGENT][NEUTRAL] That is for outpatient.
[CUSTOMER][NEUTRAL] Or just general?
[CUSTOMER][NEUTRAL] OK, perfect. All righty. You did mention that, um, so this is only for illness?
[AGENT][NEUTRAL] Is for sickness and injury.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] All [PII]. All I would need now is just a reference number.
[AGENT][NEUTRAL] The reference number would be my first name [PII], last initial of [PII] and today's date. And is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] You're welcome thank you for calling American Public Life. Have a great day as well bye.
[CUSTOMER][POSITIVE] Have a great day. Have a good week.
[CUSTOMER][NEUTRAL] Bye bye.