AccountId: 011433970860
ContactId: 18f066a0-6bfd-49d1-a8ae-fcda495e2f8c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 269160 ms
Total Talk Time (AGENT): 110637 ms
Total Talk Time (CUSTOMER): 106127 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/18f066a0-6bfd-49d1-a8ae-fcda495e2f8c_20250321T16:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, my name is [PII]. I'm calling from the provider's office. Um, I'm trying to see how this insurance, how this coordinates with their primary insurance for a patient.
[AGENT][POSITIVE] OK, I'm happy to take a look at the benefits, [PII], do you have their policy number?
[CUSTOMER][NEUTRAL] I do. It's um let's see, 02517379 and what was your name? I'm sorry, I missed it.
[AGENT][NEUTRAL] That's OK. My name is [PII], that's [PII]
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Perfect thank you.
[AGENT][NEUTRAL] And then what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] All right, [PII]. And so, um, is the patient being seen for like an outpatient office visit?
[CUSTOMER][POSITIVE] They're um they're coming for physical therapy done in the office, we build professionals.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So let me pull the pulp.
[CUSTOMER][NEUTRAL] So it looks like their primary I think it's allied.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And they have like a $5000 deductible which nothing's been met.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the patient's policy effective date was [PII]. It shows a paid to date of [PII]. So the status of the policy right now doesn't even show active.
[CUSTOMER][NEUTRAL] What?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] See that's weird because I called just yesterday. And I thought they said it was up until [PII] something of [PII].
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] But you only show up to [PII]?
[AGENT][NEUTRAL] One of [PII].
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] The plan itself under physician cover charges, um, it does state on the policy, physician cover charges do not include physical therapy.
[AGENT][NEUTRAL] So I don't
[CUSTOMER][NEGATIVE] See this girl didn't tell me any of that. The only reason I called back is because she did say they had a $100 deductible, um, and she said nothing was met, um, and she said they pay up to $4800 per year for all outpatient services.
[AGENT][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] But she didn't tell me that it doesn't include physical therapy.
[CUSTOMER][NEGATIVE] Or that it wasn't even active.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I apologize, [PII]. Yeah, I mean, I'm looking up.
[CUSTOMER][NEUTRAL] That that's OK, no problem. I mean, I'm, I'm just glad I called back so this policy does not cover anything with physical therapy.
[AGENT][NEUTRAL] Yeah, I'm looking
[AGENT][NEUTRAL] No, it doesn't. It says physician cover charges that are included are
[AGENT][NEUTRAL] Incurred in a physician's office, incurred by a covered person because of accident and sickness, but then down below, it does state, you know, does not include durable medical equipment, physical therapy, or physician office visit fee.
[AGENT][NEUTRAL] So,
[CUSTOMER][POSITIVE] Oh my goodness, OK, well, I'm glad I called back. All right, thank you so much. Do y'all give reference numbers or no?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, yeah, absolutely. It's my name with my last initial and then today's date. So last initial to my name would, would be [PII] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And today, and today is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, thank you so much. I'm glad I called back, have a good weekend, uh huh uh bye bye.
[AGENT][POSITIVE] You, you're welcome. Take care. Uh-huh. Bye-bye.