AccountId: 011433970860
ContactId: 345b78af-252a-4a70-b6a2-3ef8f8e78ea4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 398510 ms
Total Talk Time (AGENT): 161244 ms
Total Talk Time (CUSTOMER): 176449 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/345b78af-252a-4a70-b6a2-3ef8f8e78ea4_20250304T15:14_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, good morning, [PII]. My name is [PII], and let me give you, um, I don't know if the group number or the pay your ID number, what is, or the certificate number, what would you like?
[AGENT][NEUTRAL] Um, is this for your individual policy, [PII]?
[CUSTOMER][NEUTRAL] It's for, it's under my husband.
[AGENT][POSITIVE] Uh, OK, um, if you have that, uh, policy certification number, that'd be perfect.
[CUSTOMER][NEUTRAL] OK. It's 02.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 30
[CUSTOMER][NEUTRAL] 40
[CUSTOMER][NEUTRAL] 88
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you and then [PII] really quick if you don't mind, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, and I'm just gonna verify some information really quick. [PII], can I get, uh, what was your last name? I'm sorry?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you and then can I get your date of birth please?
[CUSTOMER][NEUTRAL] OK, it's under my husband's but my date of birth is [PII].
[AGENT][NEUTRAL] OK, yeah, you're listed so that's OK um and then uh can I get your mailing address please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much for verifying that information, [PII]. What could we help you with today?
[CUSTOMER][NEUTRAL] The reason I'm calling is that last year, um, I had had hand surgery and um I did therapy with Cora. So I had presented uh my main insurance, which at that time was United Healthcare, and I presented my card for APL.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And um they said it was covered and so forth. Well, today I received a bill from them, from Quora saying that American public life did not.
[CUSTOMER][NEGATIVE] Pay any of it. Um, so they told me to call you guys because they don't, they were saying that um you guys were not covering. I don't understand why.
[AGENT][NEUTRAL] OK, and this was for uh physical therapy, is that right?
[CUSTOMER][POSITIVE] Yes, for physical therapy, correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, let's take a look and see if I could find those claims. Do you happen to have a date of service, [PII], or like when.
[CUSTOMER][NEUTRAL] Yeah, well, there's, there was a lot of service, but I'll start with, it was in [PII]. It started with um
[CUSTOMER][NEUTRAL] [PII] [PII] I believe.
[AGENT][NEUTRAL] [PII]. OK, thank you. One moment, let's try to find one at least.
[CUSTOMER][NEUTRAL] It could be before, it, no, it could be before because here I have dates that are before from, no, I still, actually, I have July. I forgot it was in July. I have even before that, I have [PII].
[AGENT][NEUTRAL] OK, let's take a look.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] They did it backwards with the bill.
[CUSTOMER][NEUTRAL] I don't know. OK.
[AGENT][NEUTRAL] OK, and you did say this was uh Cora Health Services?
[CUSTOMER][NEUTRAL] Yes, core of physical therapy, coophysical therapy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, I think I might have found one. Let's see.
[CUSTOMER][NEUTRAL] I have several, I can start giving you dates one by one if you would like. It was all in the same place.
[CUSTOMER][NEUTRAL] But they, I don't know why they built it backwards, but I can start from the first date, which was [PII].
[AGENT][NEUTRAL] That's OK. um, I imagine all of those, uh, that they gave you, um, it should be the same so as long as I could find one I think we're OK, but give me just a moment I'm gonna get um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Your policy pulled up here for good measure as well.
[AGENT][NEUTRAL] OK, and this might be kind of a silly question, but it was actual physical therapy, correct? Because I know that there are other kinds, um, kinesiology of speech therapy, things like that. It was actual physical therapy.
[CUSTOMER][NEUTRAL] No, no, no, yes, it was, no, no, it was physical.
[CUSTOMER][NEUTRAL] No, no, no, I
[CUSTOMER][NEUTRAL] Yes, I went in person, uh, and they did the therapy was at [PII] when it's in [PII], [PII], yes, physical therapy, yes, in person.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, OK, just had to ask, sorry, I know it's kind of a silly thing, but.
[CUSTOMER][POSITIVE] No, no, no, no, no problem, no problem. Now that with everything being virtual and stuff, I know.
[AGENT][NEUTRAL] OK, so,
[AGENT][NEUTRAL] There's all kinds of different things. So, um, alrighty, [PII], if you don't mind, I'm going to put you on a brief hold and I'm going to reach out to our claims specialist. Um, I did find, I believe I found one of the claims from, it does say Cora Health Services and there are a lot of similar ones, so I imagine it's these, um, so give me just a moment I'll get right back with you, OK?
[CUSTOMER][NEUTRAL] Oh yeah, I know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][POSITIVE] Thank you for calling ATL. My name is [PII]. How can I assist you today?
[AGENT][NEUTRAL] Hi [PII], this is [PII] over on the care team. How are you today?
[CUSTOMER][POSITIVE] I'm good. How are you?
[AGENT][NEUTRAL] Doing all right, thank you. Um, I've got a member on the line uh calling regarding the um uh several uh claims they have for their medlink. Um, they were supposed to be for physical therapy and from what I see it denied as um.
[AGENT][NEUTRAL] You know, uh, speech occupational therapy, um, but she's insistent that it was in fact physical therapy, um, so she wanted us to take a look at that.
[CUSTOMER][NEUTRAL] OK, what's that policy number?
[AGENT][NEUTRAL] OK, that is 02304088.
[AGENT][NEUTRAL] And it is for uh part two.
[CUSTOMER][NEUTRAL] Part two, alrighty, you can put it through.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.