AccountId: 011433970860
ContactId: 193e2cf8-4360-4771-b285-86725cc92555
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 178820 ms
Total Talk Time (AGENT): 83032 ms
Total Talk Time (CUSTOMER): 59209 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/193e2cf8-4360-4771-b285-86725cc92555_20250205T22:54_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, yeah, um, my name is [PII]. I'm calling from Active Family Chiropractic, and I am just trying to find out how to find out if we are in network with you guys.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, um, I can get their policy pulled up and uh get that information for you. Um, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] Yeah, um, it's [PII].
[AGENT][NEUTRAL] Thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, let's see.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] No, you're fine.
[CUSTOMER][NEUTRAL] Uh, it
[CUSTOMER][NEUTRAL] Uh looks like 025.
[CUSTOMER][NEUTRAL] 86149.
[AGENT][NEUTRAL] OK, and then, uh, what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII], um [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that, [PII]. Alrighty, so this policy is active. Effective date was [PII], so this is a limited indemnity medical plan, so there is no set network, um, it just pays a set dollar amount per procedure or office visit you would file those claims directly to us.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Then can I find out if he has uh chiropractic benefits or do we just bill and you guys approve or not?
[AGENT][NEUTRAL] You can um give me just a moment as this is a bit of a newer policy. I don't know that I have the policy available just yet. Give me just a moment let me see.
[CUSTOMER][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] And is this in a um.
[AGENT][NEUTRAL] Outpatient facility or is this an actual chiropractic facility or physician's office?
[CUSTOMER][NEUTRAL] Um, yeah, we're a chiropractic office.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't believe so. Typically it would just be um wellness exams or office visits. Let me see.
[AGENT][NEUTRAL] Of a physical therapy benefit, but I think chiropractic is considered more of a specialist, if I'm thinking that right, yeah.
[CUSTOMER][NEUTRAL] Yeah I think so.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] So no, I don't see any chiropractic benefits for this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right perfect thank you that's all I needed.
[AGENT][POSITIVE] Alright, yeah, was there anything else I could help you with? OK, well thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] You too thanks bye.
[AGENT][POSITIVE] Thank you, bye bye.