AccountId: 011433970860
ContactId: 35ea2272-2795-4b92-bc26-81d795aa01cc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 460910 ms
Total Talk Time (AGENT): 111606 ms
Total Talk Time (CUSTOMER): 83108 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/35ea2272-2795-4b92-bc26-81d795aa01cc_20250128T20:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, yeah, my name is [PII]. I'm calling with the provider's office. I'm verifying benefits.
[AGENT][POSITIVE] Yeah, I can check benefits for you. Um, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII], no extension.
[AGENT][NEUTRAL] Thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] The policy is 02.
[CUSTOMER][NEUTRAL] 337-502
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] OK. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that, [PII]. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy. So it is designed to help with co-pay, deductible and co-insurance after major medical pays. And we're really needing to check the outpatient benefit.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and of course I will let you know.
[CUSTOMER][NEUTRAL] Yeah, um, well, I'm, I'm, I'm just trying to verify, uh, physical therapy visit done in office settings.
[AGENT][NEUTRAL] Sorry.
[AGENT][NEUTRAL] Did you, I'm sorry, you said physical therapy?
[CUSTOMER][NEUTRAL] Exactly, not in the office.
[AGENT][NEUTRAL] And then a physician's office, not in a physical therapy facility?
[CUSTOMER][NEUTRAL] Alright, uh, the office visit, yeah.
[AGENT][NEUTRAL] OK, OK. Give me just a moment, let me see if physical therapy is covered under this policy. Um, and of course, I will let you know verification of coverage is not a guarantee of payment for claims. Bear with me just a moment.
[AGENT][NEUTRAL] OK. So for this policy, office visits are not covered. Uh, physical therapy, uh, treatment in office could be, uh, but physical therapy is only going to be covered in a physic physical therapy facility.
[CUSTOMER][NEUTRAL] Physical thera therapy facility.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Do you see any of our claims paid? Can I give you the tax ID?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This was, was this for [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It was for [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, um, I can't search just using the tax ID if you have a uh claim number or a specific date of service I could search that way.
[CUSTOMER][NEUTRAL] Let me see, hold on.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Are you still there, [PII]?
[CUSTOMER][NEUTRAL] I'm, I'm here. Give me just a sec, please.
[AGENT][NEUTRAL] Sure, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, I don't, I don't have any. Let me see.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] My apologies, the system is giving me hard time. Give me just a sec. Thanks.
[AGENT][NEUTRAL] No, you're OK.
[AGENT][NEUTRAL] Sure, yeah.
[CUSTOMER][POSITIVE] Hello, ma'am. Thank, thank you, ma'am.
[AGENT][POSITIVE] Yes, of course.
[CUSTOMER][NEUTRAL] I'm sorry. OK, yes. So, yeah, well, I guess that's, that's what I needed to know. May I have your name and a current reference?
[AGENT][NEUTRAL] No, you're fine.
[AGENT][NEUTRAL] Sure, a reference number would just be my first name, last initial, and today's date, um, so my name is spelled [PII] Last initial is [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] Uh, that's what I needed to know. Thank you.
[AGENT][POSITIVE] OK, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thanks.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] I know.