AccountId: 011433970860
ContactId: 13ba0b24-9599-4bb9-96dd-7e5d804eca39
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 267750 ms
Total Talk Time (AGENT): 91075 ms
Total Talk Time (CUSTOMER): 119736 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/13ba0b24-9599-4bb9-96dd-7e5d804eca39_20250506T19:25_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Um, yes, I want to get eligibility and uh find out what type of plan a patient has.
[AGENT][POSITIVE] I'll be happy to assist with eligibility today. May I have your first name, please?
[CUSTOMER][NEUTRAL] What's that?
[AGENT][POSITIVE] I'd be happy to assist with the OK.
[CUSTOMER][NEUTRAL] Oh, it's [PII].
[CUSTOMER][NEUTRAL] Sorry, [PII]
[AGENT][POSITIVE] And [PII], if I can get a good call back number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Um, so, do do do do sorry.
[CUSTOMER][NEUTRAL] So it looks like she might have given she gave me a copy of her husband's card because she didn't have hers on her so I'm thinking her policy number might be different.
[CUSTOMER][NEUTRAL] Should I
[CUSTOMER][NEUTRAL] Give you her name and date of birth?
[AGENT][NEUTRAL] Um, did you have a social?
[CUSTOMER][NEUTRAL] Or with her and her husband had the same policy number.
[AGENT][NEUTRAL] Oh, she's the, oh.
[CUSTOMER][NEUTRAL] I don't have a surgery.
[AGENT][NEUTRAL] OK, yeah, what's her name?
[CUSTOMER][NEUTRAL] Her name is [PII].
[AGENT][NEUTRAL] And do you have an address for her?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] And it looks like her license has a different address, good grief, um.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active, effective date is [PII], and let me give you that policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 2573495.
[CUSTOMER][NEUTRAL] And what um is this a supplemental Medicare plan?
[AGENT][NEUTRAL] It's not Medicare, it's just her commercial gap policy.
[CUSTOMER][NEUTRAL] Could I get um.
[CUSTOMER][POSITIVE] Benefits for that. She has a Blue Cross policy and she gave me this information as well.
[AGENT][NEUTRAL] Alright, please be advised the verification of coverage is not a guarantee of payment and you show the policy is active and were you calling for inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] It's an outpatient physical therapy in an office setting.
[AGENT][NEUTRAL] Alright, I do show for outpatient, the calendar year maximum is $6000 and patient also has a $100 deductible which she's already met.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I'm sorry, a coworker was talking. I got it's a 60 I mean a 6000 max payout.
[CUSTOMER][NEUTRAL] A $100 deductible that's been met.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And did you say something prior to that?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, so like her Blue Cross policy, she has a $40 copay for PT, uh, office visits. Do y'all cover that $40 or do I still need to collect that $40 from her?
[AGENT][NEUTRAL] No, we would cover that, so you would, um, once you build Blue Cross and they sent you the EOB then you would send the claim and EOB to us and then we would process and pay her patient responsibility.
[CUSTOMER][NEUTRAL] All right, so it doesn't cross over from Blue Cross.
[AGENT][NEUTRAL] What do you mean?
[CUSTOMER][NEUTRAL] So Blue Cross doesn't uh send directly to y'all we have to send it to y'all.
[AGENT][NEGATIVE] No, no, no, no, no, they, yeah, no, they don't, no.
[CUSTOMER][MIXED] They don't, OK, so it does not. OK, perfect.
[CUSTOMER][NEUTRAL] And what um
[CUSTOMER][NEUTRAL] What's your name again?
[AGENT][NEUTRAL] [PII], was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Um, just a call reference number if possible.
[AGENT][NEUTRAL] OK, reference is my name [PII], and the date and time of the call.
[CUSTOMER][POSITIVE] Alrighty thank you so much.
[AGENT][POSITIVE] Thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.