AccountId: 011433970860
ContactId: 23ed7e67-9cc8-40df-a525-861ad0770178
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 511809 ms
Total Talk Time (AGENT): 139179 ms
Total Talk Time (CUSTOMER): 228656 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/23ed7e67-9cc8-40df-a525-861ad0770178_20250414T17:05_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name's uh [PII] with North Florida Therapy Associates. We have a patient whose mom is saying that she has secondary insurance with American Public Life.
[CUSTOMER][NEUTRAL] Um, and I'm trying to get a little bit of information to see if um this even applies to her child.
[AGENT][NEUTRAL] OK. I'm sorry. What was your name?
[CUSTOMER][NEUTRAL] My name is [PII] with North Florida Therapy Associates.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mr. [PII].
[AGENT][NEUTRAL] Do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Sure, um, actually I'll give you my cell because I might be leaving the office soon [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] I don't have her policy number um I can check with her to get that. I guess you would need that to know whether her she has, she has dependent on her policy, right?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Right. Or do you have her social?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let me pull it up here.
[CUSTOMER][NEUTRAL] I don't know if I've got that either.
[CUSTOMER][NEUTRAL] Bear with me just a second, pulling up, opening her chart.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] We got a social on here.
[CUSTOMER][NEUTRAL] full page or now let's see.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, I have a name and a date of birth for the patient.
[AGENT][NEUTRAL] OK. Is the, is the policy in her name?
[CUSTOMER][NEUTRAL] In the patient's name or?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] The mom's mom's name, uh, well, the.
[AGENT][NEUTRAL] Whose name is the policy?
[CUSTOMER][NEUTRAL] I, I'd have to assume mom, the patient's only [PII] old. I.
[CUSTOMER][NEUTRAL] I guess I need to get more info from um.
[CUSTOMER][NEUTRAL] She just mentioned it because she thought that it would cover her copays her primary insurance is Blue Cross Blue Shield, um, and she was thinking this would cover her co-pays.
[AGENT][NEUTRAL] Yeah, I would have to have her policy number, social, or whoever name the policy is in.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Well, I
[AGENT][NEUTRAL] I can try her name. What is her name?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, the last name is.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] No [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] yes.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Right. And the first name?
[CUSTOMER][NEUTRAL] Um, the, well, the patient's first name is [PII] Mom's name is [PII].
[AGENT][NEUTRAL] OK. How do you spell her first name?
[CUSTOMER][NEUTRAL] For the patient or the mom?
[AGENT][NEUTRAL] The mom.
[CUSTOMER][NEUTRAL] Mom is [PII], just like [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what was her last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hold on just a moment.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, I didn't see it under the mother's name.
[AGENT][NEUTRAL] Let's see, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's the date of birth for [PII]?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][POSITIVE] Thank you, [PII]. And you're wanting benefits?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK. Her policy number with us is 02.
[AGENT][NEUTRAL] 419189.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I can help you with those benefits. Is it for outpatient, inpatient or doctor's office?
[CUSTOMER][NEUTRAL] 89 OK.
[CUSTOMER][NEUTRAL] It's, it would be, well, outpatient, it's for uh speech therapy, occupational therapy, and physical therapy.
[AGENT][NEUTRAL] OK, the effective date is [PII]. Any benefits given over the phone is not a guarantee of payment.
[AGENT][NEUTRAL] This policy does.
[AGENT][NEUTRAL] Uh, coordinate with the primary insurance, whatever her primary applies to her deductible co-pay or co-insurance only.
[AGENT][NEUTRAL] We'll pick up to certain amounts. Now, occupational therapy is not covered and speech therapy is not covered. Now, physical therapy would be covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we would pay for physical therapy up to $500 per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, is there a visit limit per year or anything like that?
[AGENT][NEUTRAL] No, we'll just pay up to that 500 per calendar day.
[CUSTOMER][NEUTRAL] OK, um, next question, do.
[CUSTOMER][NEUTRAL] Do we as the providers uh send the claim to you or does mom send the claim to you and work that out herself?
[AGENT][NEUTRAL] Uh, you all can send it if you would like, yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We would need the claim and the explanation of benefits from her primary insurance.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, PT is covered. OT and ST not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and the policy number was 02419189.
[AGENT][NEUTRAL] 89. Uh-huh.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Let's see, do you have info on your website about filing claims? I guess we don't need to be in network with you or anything like that.
[AGENT][NEUTRAL] It doesn't have a network. It just mirrors her major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, OK, and filing paper form.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] File online OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][POSITIVE] I think that's enough to get me started here and I can work on this.
[CUSTOMER][POSITIVE] OK, well I appreciate your time. What was your name?
[AGENT][NEUTRAL] My name is [PII]. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] I think that's it today. I appreciate it.
[AGENT][POSITIVE] You're welcome. Thank you, Mr. [PII], for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too bye now.
[AGENT][NEUTRAL] Bye bye.