AccountId: 011433970860
ContactId: 28d134b3-82c5-4b4d-b079-22dbf48e7f11
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 211240 ms
Total Talk Time (AGENT): 103341 ms
Total Talk Time (CUSTOMER): 43562 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/28d134b3-82c5-4b4d-b079-22dbf48e7f11_20250605T18:43_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII]. I'm calling from uh Cora Physical Therapy. I was trying to verify benefits on a patient.
[AGENT][NEUTRAL] OK, [PII], you're only needing benefit information. You do not need eligibility, is that correct?
[CUSTOMER][NEUTRAL] Uh, well, we will try to see if the patient, um, has benefits for outpatient physical therapy.
[AGENT][NEUTRAL] I can, OK, I can help you with benefits, [PII], and what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And did you say the area code was [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] 02012.
[CUSTOMER][NEUTRAL] 930 M as in Mary L. H.
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name, please, and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so on the supplemental policy she does have benefits of our outpatient services for covered outpatient services, the benefit maximum is $500 per calendar day again for covered services, and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now when the claim, because it is a supplement to her primary insurance, when the claim is submitted to APL for review, we must also receive a copy of her primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have reviewed and processed our claim here at APL, we do have a portal Lydia, in which you all should be able to check her claim status and and the website for our portal is located at secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Could be $500 per calendar day.
[AGENT][NEUTRAL] For covered outpatient services, that is the benefit maximum.
[CUSTOMER][POSITIVE] Oh. Thank you so much. And may I have a reference number, please?
[AGENT][NEUTRAL] Yes, ma'am, you would use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] Oh, thank you. Have a good day.
[AGENT][POSITIVE] Well, you're very welcome and thank you for calling APL Lydia if that's all I can help you with. I hope you have a nice rest of your day.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] Thank you.