AccountId: 011433970860
ContactId: 2a3c8ad3-9eef-411e-abf0-67487d6113d1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 242289 ms
Total Talk Time (AGENT): 131047 ms
Total Talk Time (CUSTOMER): 89056 ms
Interruptions: 1
Overall Sentiment: AGENT=2.5, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/2a3c8ad3-9eef-411e-abf0-67487d6113d1_20250429T19:39_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] I'm sorry, what was your name, ma'am?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], can you please spell, uh, spell your name?
[AGENT][NEUTRAL] I sure can. It's [PII] yes.
[CUSTOMER][NEUTRAL] [PII], OK, [PII], I need some information and eligibility for one of our patients who's trying to apply their gap insurance to see if they're covered.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] OK, I'll be glad to help you. Go ahead and give me your name and the member's policy number.
[CUSTOMER][NEUTRAL] My name is [PII]. It's S U S Y.
[AGENT][NEUTRAL] The member's policy number, [PII].
[CUSTOMER][NEUTRAL] It is 02501700.
[AGENT][NEUTRAL] Alright, [PII], thank you for all that information. Now while I'm pulling the policy up, go ahead and give me a good return telephone call number please, ma'am.
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alrighty, thank you for all that information, so now your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, her name is [PII].
[CUSTOMER][NEUTRAL] Her date of birth is [PII].
[AGENT][NEUTRAL] Alrighty, thank you for all that information. Uh it looks like Ida is the insured on this medical supplemental plan. I do show the original effective date is [PII], patient is current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but you did say you want some type of benefit. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yeah, she's gonna be coming in to do physical therapy into our office and she wants to know if um because she hasn't reached her deductible um for her regular insurance and wants to see if the gap is gonna pick it up.
[AGENT][NEUTRAL] OK, let me get her benefit plan pulled up. Let's see what she has.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right. Of course, now what we are is her medical supplemental plan. So the only thing that we would pick up and pay for is anything that is applied towards her deductible, co-pay, or co-insurance at her primary insurance carrier for sickness and injury only, that the routine here is covered no matter what.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] But it looks like under this outpatient benefit, she has a zero deductible, no pre-cert, and physical therapy is a covered benefit with a $3000 max payable per calendar year.
[CUSTOMER][NEUTRAL] So it will pick it up. OK, so 3000 max.
[AGENT][POSITIVE] That is correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] Payable per year.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, give me a second.
[AGENT][POSITIVE] No problem. Take your time, [PII].
[CUSTOMER][NEUTRAL] The that.
[CUSTOMER][NEUTRAL] OK, 3000 likes per year active. OK, can I have a reference number to our call?
[AGENT][NEUTRAL] Well, is that all that I can help answer for you today, [PII]?
[CUSTOMER][NEUTRAL] Yeah, is there any other information you think I should um be aware of regarding her?
[AGENT][NEUTRAL] Uh, no, ma'am, not as far as our benefits go, that's it. But yes, ma'am. Well, that's all I can help you with. We don't give a reference number, but you can use my name in today's date, [PII], if you need to do so, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it would be today's date, Am I correct?
[AGENT][POSITIVE] Yes, ma'am, that is correct.
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][POSITIVE] Oh, [PII], you're so welcome, [PII], and thanks for calling APO. You have a great rest of your day, OK?
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][POSITIVE] You too OK bye bye.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.