AccountId: 011433970860
ContactId: 08446763-e2ed-4859-a5a0-9bcc9c4c469e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 262549 ms
Total Talk Time (AGENT): 72243 ms
Total Talk Time (CUSTOMER): 126858 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=-1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/08446763-e2ed-4859-a5a0-9bcc9c4c469e_20250113T14:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes. Uh, this is [PII]. My husband has insurance through you. And I called, I think it was Friday to see if they care, uh, cover.
[CUSTOMER][NEUTRAL] Uh, physical therapy, and they told me yes.
[CUSTOMER][NEUTRAL] And so, they told me, go ahead and go and, you know, put in the claim and everything. Now, the physical therapy people said that they contacted you and you guys said no.
[AGENT][POSITIVE] OK. Yes, ma'am. I can assist you with those benefits. Um, first, I'll need your name and a good callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] OK, my phone number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And the insurance is under [PII].
[AGENT][NEUTRAL] And your name, please?
[CUSTOMER][NEUTRAL] And do you want the
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, the policy number is 025.
[CUSTOMER][NEUTRAL] Looks like 67.
[CUSTOMER][NEUTRAL] 206.
[AGENT][NEUTRAL] Hey, [PII] and um please verify um your date of birth and your mailing address.
[CUSTOMER][NEUTRAL] OK, my date of birth is [PII].
[CUSTOMER][NEUTRAL] And mailing address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And one moment, I'm pulling up your benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, yes, ma'am. I'm showing that physical therapy is covered under the outpatient visit benefit and under your policy for outpatient benefits, we cover up to $30 per benefit and you get 4 visits per calendar year.
[CUSTOMER][NEUTRAL] OK. You only cover $30?
[AGENT][NEUTRAL] Yes, ma'am. Cover up to 30.
[CUSTOMER][NEUTRAL] Or is that my part?
[AGENT][NEUTRAL] That's the part that, well, that's the part that we pay, we cover up to $30 per visit.
[CUSTOMER][NEUTRAL] Oh, up to $30. Because like the bill's $300 you'll pay $270.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] No, we'll only pay 30.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh, gotcha.
[AGENT][NEUTRAL] We'll only pay 30. Mhm.
[CUSTOMER][NEUTRAL] Only pay $30 OK.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEGATIVE] Well, I'll see if I'm, the person I talked to on Friday didn't tell me all this. And I had a physical therapy, and they tried to catch me and cancel it before I was in there. Well, I was already in there. So they let this
[CUSTOMER][NEGATIVE] Oh man. So now I got to cancel Wednesdays then, cause I can't afford $270.
[AGENT][NEUTRAL] Mm, I apologize, ma'am. Yeah, we only cover 2:30.
[CUSTOMER][NEGATIVE] Cause I'm unemployed.
[AGENT][POSITIVE] Oh wow.
[CUSTOMER][NEGATIVE] Yeah, um, I'm unemployed and I'm not getting unemployment because of my knee. So,
[CUSTOMER][NEGATIVE] And I can't go get a job because of my knee.
[AGENT][NEUTRAL] Well, I'm so sorry, ma'am. Uh yeah, we only cover up to 30 for all office visits and services provided in office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So the, whoever told me Friday, they said, yeah, they take care of them. And so, oh my gosh. OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Nope, that's it.
[AGENT][POSITIVE] OK. Well, I thank you again for calling APL ma'am. You have a great rest of your day. Mm bye.