AccountId: 011433970860
ContactId: 23837fbe-c513-453d-ad57-33fc62b9ba65
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266799 ms
Total Talk Time (AGENT): 163785 ms
Total Talk Time (CUSTOMER): 104339 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/23837fbe-c513-453d-ad57-33fc62b9ba65_20250415T20:41_UTC.wav
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[AGENT][NEUTRAL] For contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, my name is [PII] and I'm calling um
[CUSTOMER][NEUTRAL] Because uh a potential patient called up our physical therapy location and gave us this as their insurance.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you wanted to see whether we have a physical therapy or?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] No, no, we're a physical therapist.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm not completely sure about your company. Is it like an Alec? Is it a third party? I'm, I've never heard of you, like, so it's not really a commercial insurance, is that correct?
[AGENT][NEUTRAL] Yes, yes, we are. We are a secondary or gap insurance and what we do is we um uh we are meant to pay the deductible, co-payment or co-insurance from their major medical.
[CUSTOMER][NEUTRAL] So you're a gap insurance, so if there's a, like a, like a Cobra, is it?
[AGENT][NEUTRAL] Well, no, it's just, I, I don't.
[CUSTOMER][NEUTRAL] When you say gap insurance, what does that mean?
[AGENT][NEUTRAL] Well, it means that they, they have a major medical, the, the, the, um, with a deductible, um.
[CUSTOMER][NEUTRAL] So they already have an insurance.
[AGENT][NEUTRAL] Yes, so, yes, so what we are is we're their secondary insurance and what we and with their primary insurance, they usually have a large deductible, and what we do is um as their secondary insurance, we pick up the deductible, co-payment or co-insurance.
[CUSTOMER][NEUTRAL] OK, the second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and pay that while, while, uh, while they're waiting for to meet their deductible with their major medical. No. Uh, some policies do cover physical therapy, some of them don't. Um, do you have the policy there with you, [PII], that we could look up and see if, if, uh,
[CUSTOMER][NEUTRAL] I do and here's here's where I'm a bit confused then because if you're telling me he's a gap insurance and you're the secondary, uh, he didn't give me his primary so that so that's why I'm a bit confused.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, yeah, we, you would certainly need that as well. So you, you would need his primary insurance.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] Oh, I can give you his ID. Uh, it's 02595525.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] His name is [PII], I think it is [PII].
[AGENT][NEUTRAL] Thank you. And is there a
[AGENT][NEUTRAL] A callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] I appreciate that. Thank you. Um, and that's why we, we like to get their, their policy, um, information because uh this is not, this is not a secondary insurance. Among the, the many different types of insurance that we sell, um, there is also, uh, what is called a, a, um,
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] Uh, a hospital indemnity policy. Now, hospital indemnity policy really just means that it's, um, it pays a flat rate benefit for very specific services. Uh, and I'm just right, and sometimes physical therapy is covered, sometimes it's not. So that's what I'm gonna check here and see what, um, because usually these uh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] We're not a hospital though.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right, but, but I, I, I, I, yeah, I know, I, I understand what you mean. I just need to get his primary insurance then, um.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes, it it
[CUSTOMER][NEUTRAL] I guess that's what I need to get.
[AGENT][NEUTRAL] Yeah, this is the only insurance that he has, um, then, uh, yeah, it's not, um, it just pays a flat rate benefit for, for certain hospital services, sometimes an office visit, um, but, uh, he, he may have, uh, because this is just a, a very limited benefit policy, it's possible that he has another policy besides this one. so, uh,
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So he may um
[AGENT][NEUTRAL] Yeah, he may have another policy that uh for this. Now, sometimes they do, they do uh pay physical therapy and if they do, um, then they uh they let us know on that, but I'm, I'm not saying that this pays physical therapy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It so it doesn't. OK, so I don't suppose you know what his policy, his main policy is, do you? You, you don't have any records of that.
[AGENT][NEUTRAL] No, no, I'm sorry. I, I really don't. Um, that, this is the only one that we know of. Um.
[CUSTOMER][NEUTRAL] OK, that's fine. I, I.
[CUSTOMER][POSITIVE] I'll call him and ask him what his main policy is because um yeah, OK, that's great, thanks for your help.
[AGENT][POSITIVE] OK, well, if there's nothing else I can help with and thanks for contacting ATL. Have a very good day.