AccountId: 011433970860
ContactId: 1f230440-3440-4994-82f4-0bb5c54dd238
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 185919 ms
Total Talk Time (AGENT): 121368 ms
Total Talk Time (CUSTOMER): 37485 ms
Interruptions: 0
Overall Sentiment: AGENT=2.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/1f230440-3440-4994-82f4-0bb5c54dd238_20250415T18:38_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm just calling because I just need to verify patients benefits for physical therapy.
[AGENT][POSITIVE] OK, I'll be glad to help you. Go ahead and give me your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] My name is [PII], and the member's name a member's policy is 02458749 [PII].
[AGENT][NEUTRAL] Alright, [PII], thank you for all that information. Now, while I'm pulling this up, go ahead and give me a good return telephone card number, please, ma'am.
[CUSTOMER][NEUTRAL] 3, yes ma'am, [PII].
[AGENT][POSITIVE] Alrighty [PII], thank you so much for all that information. Now, what did you say your uh patient's name was?
[CUSTOMER][NEUTRAL] [PII] [PII] [PII].
[AGENT][POSITIVE] Great.
[AGENT][NEUTRAL] All right, [PII], thank you for all that information. It looks like [PII] is a dependent spouse on this medical supplemental plan to show the original effective date as when [PII] patient is current and active, but I must advise that verification of coverage is not a guarantee of payment on a claim, but you did say you want physical therapy benefits. Is that correct, [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Alright, let me get over there. Let's see what their benefits are.
[AGENT][NEUTRAL] Well it looks like they have a zero deductible and they have a $4500 benefit payable per calendar year with no pre-start.
[AGENT][NEUTRAL] And of course what we are is just.
[CUSTOMER][NEUTRAL] This again, has any been accumulated yet?
[AGENT][NEUTRAL] Let's see, and of course that what we are now is the medical supplemental plan. So the only thing that we would pick up and pay on is anything that is applied towards that patient's deductible, co-pay, or co-insurance at the primary insurance carrier for sickness and injury only. So make sure you send the bill along with that primary EOB so we can coordinate that benefit. Alright, so you're asking what has been met as of today. Let's see.
[AGENT][NEUTRAL] So far as of today, uh, patient has met $550 of that maximum per calendar year for [PII].
[CUSTOMER][NEUTRAL] OK, perfect. Alright, can I have your name and and this reference number please?
[AGENT][NEUTRAL] Is that all that I can help answer for you today, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alrighty. Uh, we don't give reference number [PII], but you can use my name as today's date and my name is [PII] spelled [PII]
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] Yes, ma'am, [PII], thanks for calling AP.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][POSITIVE] Yeah, you have a great rest of your day.
[CUSTOMER][NEUTRAL] You as well.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.
[CUSTOMER][NEUTRAL] Mm bye.