AccountId: 011433970860
ContactId: 1808f7a3-9655-4cd3-9b1c-6a6e98a17a64
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 215529 ms
Total Talk Time (AGENT): 83388 ms
Total Talk Time (CUSTOMER): 57129 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/1808f7a3-9655-4cd3-9b1c-6a6e98a17a64_20241231T17:12_UTC.wav
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[AGENT][NEUTRAL] Thank you. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi sir, I needed to verify benefits for this member to see if her therapy uh is covered under this plan.
[AGENT][POSITIVE] OK, I'm happy to verify benefits today. Do you have their policy number?
[CUSTOMER][NEUTRAL] I have.
[CUSTOMER][NEUTRAL] I have the benefit certificate number, is that OK?
[AGENT][POSITIVE] Yeah, that should work.
[CUSTOMER][NEUTRAL] OK, 023218-87.
[CUSTOMER][NEUTRAL] ML 8.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Thank you for that. 1 2nd.
[CUSTOMER][NEUTRAL] And her date of birth is [PII].
[AGENT][NEUTRAL] All right. And then the patient's first and last name, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Alright, uh, patients plan is active. The effective date is [PII]. We're the secondary insurance, so this covers deductible, co-pay, co-insurance. The primary does not, and it looks like their outpatient benefit max for the calendar year on this plan is 1500.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] All right, so it does, it would cover therapy?
[CUSTOMER][NEUTRAL] If it's a co-pay?
[AGENT][NEUTRAL] Uh, let me double check. Some of these will cover an office visit fee, some of them don't. So I just wanna make sure. Give me one sec.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Sure, take care.
[AGENT][NEGATIVE] Mhm. Nothing has been used this year though it doesn't look like.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Let's see here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let me see that.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] So it looks like it does cover seeing a physical therapy, like a physical therapist and an office or center. It's gonna cover treatment, but it does not cover a physician office visit fee.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, that sounds doable. I'll go ahead and have them submit the bill.
[AGENT][POSITIVE] OK, is there anything else? You're welcome. Anything else I can check on for you? You too. Thanks for calling. Have a good one.
[CUSTOMER][POSITIVE] Perfect thank you so much.
[CUSTOMER][POSITIVE] That would be it. Happy New Year. Thank you. All right, thanks, thanks, bye.
[AGENT][NEUTRAL] Bye bye.