AccountId: 011433970860
ContactId: 3025f84c-ea67-44dc-af66-64180f246e6c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241720 ms
Total Talk Time (AGENT): 92515 ms
Total Talk Time (CUSTOMER): 68100 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/3025f84c-ea67-44dc-af66-64180f246e6c_20250313T22:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling to confirm this patient has secondary gap coverage with you guys and if there's an outpatient dollar amount they have for physical therapy for the year.
[AGENT][NEUTRAL] OK, let's take a look. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes I do. I have 021.
[CUSTOMER][NEUTRAL] 262.
[CUSTOMER][NEUTRAL] 25 M like Mike L like Larry, and the number 8.
[AGENT][NEUTRAL] Thank you. And if I can get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] That is [PII], [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So looks like.
[AGENT][NEUTRAL] The effective date for the member is [PII].
[AGENT][NEUTRAL] And the patient is still active.
[AGENT][NEUTRAL] Looks like they're outpatient benefits. Let's see.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Just a different one. Give me just a second, sorry.
[AGENT][NEUTRAL] Alright, so it looks like this plan has an inpatient and outpatient combined max and it looks like.
[AGENT][NEUTRAL] It's $6000.
[CUSTOMER][NEUTRAL] $1000.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Combined, OK, and have they used any of that amount for the year? And can they use that for physical therapy because I know certain plans doesn't cover it for some reason.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, that's true. Let's see. So I don't show anything that's been used.
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, so it looks like physical therapy is listed on here, so um it looks like it is the covered benefit.
[CUSTOMER][NEUTRAL] OK, perfect. Alright, and is there any group name group number associated with the policy?
[AGENT][NEUTRAL] Let's see here.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Uh, the group name is Mr. Glass doors and Windows.
[CUSTOMER][NEUTRAL] Uh, doors and windows.
[AGENT][NEUTRAL] And the group number is 26773.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then the PO box for claims, is it the 248,950 Oklahoma City, Oklahoma 73124?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Yeah, that is correct, yeah.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Perfect. Alright, that's exactly what I needed for the patient today, [PII]. Is there any uh call reference number we can use for the call?
[AGENT][NEUTRAL] Yeah, absolutely. Call reference is my name with my last initials and today's date. My name again is [PII].
[CUSTOMER][NEUTRAL] Because it's all. OK, you said your name and today's date is the reference number, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Perfect. Alright, thank you so much for your time. I hope you enjoy the rest of your day.
[AGENT][NEUTRAL] You too. Bye.
[CUSTOMER][POSITIVE] Thank you. Bye.