AccountId: 011433970860
ContactId: 23f997fa-9bb5-4be6-bceb-6ac70e354c79
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240119 ms
Total Talk Time (AGENT): 111989 ms
Total Talk Time (CUSTOMER): 89980 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/23f997fa-9bb5-4be6-bceb-6ac70e354c79_20250311T14:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling to confirm this patient's uh coverage with you guys if they have any outpatient hospital coverage for physical therapy.
[AGENT][NEUTRAL] May I have your name and a callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. Callback number [PII].
[AGENT][NEUTRAL] And may I please have the policy?
[CUSTOMER][NEUTRAL] Yes, I have 02214106, M like Mary, L like Larry, and the number 8.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy you're calling in for outpatient benefits. I'm pulling that information up for you now.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] You're welcome, and verification of coverage does not guarantee the payment of the claim. For outpatients, the member has up to $1500 per calendar year. It will go towards the primary insurance deductible, co-insurance, or co-pay. This policy is for sickness and injury only. It will not cover for any preventative or wellness. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Oh my [PII]
[CUSTOMER][NEUTRAL] Um, so yeah, just to make sure the outpatient $1500 it can be used for physical therapy because I know some plans, they don't cover it. So I just wanna make sure um it does cover therapy.
[AGENT][NEUTRAL] It does for outpatient yes for field therapy they have up to $1500 per calendar year.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK perfect and then um can you confirm the group name and group number that she has on the policy?
[AGENT][NEUTRAL] Let me pull that up for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And just in case I didn't give the disclaimer, verification of coverage does not guarantee the payment of the claim, and for the group number, it is showing 24864, the group name.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] Christian school of Dad County.
[CUSTOMER][NEUTRAL] Christian school without the S of Dade County.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Got you. OK, and then, uh, last question for you, is there, where's the [PII] box we will send the claim to for Milly?
[AGENT][NEUTRAL] For claim submission, that would be [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and would you like the fax and the secure portal information as well?
[CUSTOMER][NEUTRAL] Um, no, that's OK, that's all I needed in this case. Um, so just to repeat it real quick, you said [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, now that number was 248,950 for [PII].
[CUSTOMER][NEUTRAL] Uh-huh, [PII], uh huh.
[AGENT][NEUTRAL] OK, yes, that would be it.
[CUSTOMER][POSITIVE] Perfect. Alright, that's all I needed for today. [PII], is your name spelled [PII]?
[AGENT][NEUTRAL] It is spelled [PII] with the last [PII] [PII] and today's date as the call reference.
[CUSTOMER][NEUTRAL] So we
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] Perfect. Alright, thank you so much for your time. I hope you enjoy the rest of your day.
[AGENT][POSITIVE] Thank you and thank you so much for calling American Public Life. Enjoy the rest of your day as well.
[CUSTOMER][POSITIVE] Thank you. Bye.