AccountId: 011433970860
ContactId: 35f42bb4-fc4b-4ea5-95ed-6c8e5ffc4190
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 306299 ms
Total Talk Time (AGENT): 134772 ms
Total Talk Time (CUSTOMER): 59525 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/35f42bb4-fc4b-4ea5-95ed-6c8e5ffc4190_20250203T16:03_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from Nicholas Children's Hospital. I need to verify eligibility for 2 patients.
[AGENT][NEUTRAL] OK, sure. I can assist you with the eligibility. May I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected, Miss [PII].
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] 01480322
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] Last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] OK, what's the other member?
[CUSTOMER][NEUTRAL] And the other number is 243.
[CUSTOMER][NEUTRAL] 0725.
[AGENT][NEUTRAL] 0, 2430725. So it's different policies. OK, bear with me just a second. OK, one moment. Let me make a note on this one and let me go ahead and give you this one then. OK, um, for [PII], we have an effective date of uh [PII]. It is active at the moment and this is one of our secondary supplemental plans to the major medical.
[CUSTOMER][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let me make a note on this [PII] moment.
[AGENT][NEUTRAL] And you said you just need eligibility. Any other information on this one?
[CUSTOMER][NEUTRAL] Um, the benefits for PT, have they exhausted any of that max that you guys cover?
[AGENT][NEUTRAL] OK, I'll have to check on that. One moment.
[CUSTOMER][NEUTRAL] I forget how much it is.
[CUSTOMER][NEUTRAL] Oh, I think, I think they only you guys cover up to $500 per day, so I don't know if there's a max.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. So for her, and yeah, there's no max. It's just $500 per day. Um, and you said it was for physical therapy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me make sure it's the cover service. One moment.
[AGENT][POSITIVE] I'm so sorry my system is moving a little slow. I do apologize for that.
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] OK, so yes, physical therapy is part of it. Yes, it's $500 per day and this is for [PII]. Um, let me go ahead and pull the other policy. You said the policy number is 02430725?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, what's the name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And this one would be for physical therapy as well.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is not a guarantee of payment, just a verification of coverage. We have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plans for the major medical. Um let me check and see if it cover and
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and this one also has that $500 per day, and I think it's gonna be the same thing, but let me just double check. Let me pull the certificate.
[AGENT][NEUTRAL] OK, yes, physical therapy is also part of that outpatient maximum.
[CUSTOMER][POSITIVE] OK. All right. I appreciate it. Thank you so much.
[AGENT][NEUTRAL] So it's 5 $100 per day.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Nope, that is it.
[AGENT][POSITIVE] OK, thank you for calling APL. Have a good week, Miss [PII].
[CUSTOMER][POSITIVE] Thanks you too.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Bye bye.