AccountId: 011433970860
ContactId: 0079cf7f-7233-4371-8d9c-b459c33ced17
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190470 ms
Total Talk Time (AGENT): 75731 ms
Total Talk Time (CUSTOMER): 80857 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/0079cf7f-7233-4371-8d9c-b459c33ced17_20250320T14:42_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Orthopedic Center of South Florida in regards to a mutual member.
[AGENT][POSITIVE] How can I assist you today?
[CUSTOMER][NEUTRAL] I wanted to see the patient states that her um policy with American Life should cover her co-pays, so I just needed to verify that.
[AGENT][NEUTRAL] Sure. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Sure, my callback number is [PII].
[AGENT][NEUTRAL] The policy number of the member?
[CUSTOMER][NEUTRAL] It is 025799973 M like Michael, L like Larry, the number 8.
[AGENT][NEUTRAL] [PII], could you verify that patient's name and date of birth, and I'll be able to assist you.
[CUSTOMER][NEUTRAL] The patient's name and date is [PII], [PII].
[AGENT][NEUTRAL] And you're calling to verify benefits eligibility for office visit?
[AGENT][NEUTRAL] For outpatient.
[CUSTOMER][NEUTRAL] So, um, it, it's, yes, office visits for physical therapy.
[AGENT][NEUTRAL] This member's policy has been active since [PII] and it's currently active.
[AGENT][NEUTRAL] Her physical therapy falls under her outpatient benefits of $250 per calendar day, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] I'm sorry, can you repeat that?
[AGENT][NEUTRAL] Her benefits amount is $250 per calendar day for outpatient services, and her physical therapy falls under her outpatient benefits, and this is not a guarantee of benefits, just a disclaimer of the policy's coverage.
[AGENT][NEUTRAL] Could you provide me with the spelling of your name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] It covers up to $250 because our copay with her primary insurance. OK, so I'm, I'm not understanding, so her copay with her primary insurance is $55 for physical therapy every day or every time she comes in. So you guys do pay that or you don't pay that?
[AGENT][NEUTRAL] Per calendar day.
[AGENT][NEUTRAL] So her benefits is $250 per calendar day. So each day her benefit amount is $250.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So anything past $250 she's responsible for per day.
[AGENT][NEUTRAL] That is correct, per day.
[CUSTOMER][NEUTRAL] Uh-huh, got it. Sorry, there's a lot of fancy words. Is there a
[AGENT][POSITIVE] No, no worries, no worries.
[CUSTOMER][NEUTRAL] Is there a reference number for this call?
[AGENT][NEUTRAL] We don't provide those [PII], however, you can use my name in today's date as a reference. It's [PII], and today's date.
[CUSTOMER][POSITIVE] Perfect and today is the [PII]. Alright, I appreciate it thank you so much for your help.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a great day. Goodbye.
[CUSTOMER][NEUTRAL] You too bye bye.