AccountId: 011433970860
ContactId: 244256eb-08e0-483d-b488-869451e50735
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 213000 ms
Total Talk Time (AGENT): 105202 ms
Total Talk Time (CUSTOMER): 43902 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/244256eb-08e0-483d-b488-869451e50735_20250611T20:02_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from Nicholas Children's. I needed to verify eligibility and benefits for a patient.
[AGENT][NEUTRAL] I can help with eligibility and benefits, and I'm sorry I didn't catch your name.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], thank you. What's that policy number we're looking at today?
[CUSTOMER][NEUTRAL] 02415324.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] First name is [PII] Last name is [PII] [PII], date of birth.
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII] and it's active. Now, this is a secondary or gap insurance. It's meant to pick up the deductible, co-payment or co-insurance for in and out of hospital settings.
[AGENT][NEUTRAL] Um, there's also a physician's, uh, benefits, uh, for 4 office visits per calendar year. Is there anything in particular that I could tell you?
[AGENT][NEUTRAL] About the secondary or gap insurance, any particular benefits.
[CUSTOMER][NEUTRAL] Physical therapy?
[CUSTOMER][NEUTRAL] Uh, for physical therapy?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] He is just a second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] I apologize
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] OK, so for physical therapy.
[AGENT][NEUTRAL] I'm just checking
[AGENT][NEUTRAL] So what is covered in the outpatient benefits?
[AGENT][NEUTRAL] Outpatient surgery, outpatient testing. Uh, it doesn't look like there's any benefit for physical therapy uh on this policy. I'm just checking again just to be absolutely certain.
[AGENT][NEUTRAL] And I did not show that that is the case, so I'm not seeing anything for physical therapy that would be covered.
[CUSTOMER][NEUTRAL] OK. And then, so if the physical therapy was done outpatient hospital, would they have coverage or no?
[AGENT][NEUTRAL] No, it doesn't look like it. What I have is for emergency room, urgent care, um, surgery.
[AGENT][NEUTRAL] Uh, diagnostic testing.
[AGENT][NEUTRAL] Uh, mental illness treatments, uh, and then there's the office visit that we just talked about, uh, but no, I don't show anything for physical therapy.
[AGENT][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK, and is there a reference number for the call?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We'll use this in today's date as our reference. Is there anything else at all that I can tell you about the secondary or gap insurance?
[CUSTOMER][NEUTRAL] Nope, that is it.
[AGENT][POSITIVE] OK, well, thank you very much for contacting ATL. Hope you have a very good day. Thank you for calling.