AccountId: 011433970860
ContactId: 3689a047-bfba-4220-b029-ad5a7f73be66
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 279420 ms
Total Talk Time (AGENT): 157058 ms
Total Talk Time (CUSTOMER): 39048 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/3689a047-bfba-4220-b029-ad5a7f73be66_20250114T14:12_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], yes, I need to verify benefit for physical therapy.
[AGENT][NEUTRAL] OK, you're needing to verify outpatient benefits for physical therapy, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] This is [PII].
[AGENT][POSITIVE] Thank you and [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] 02331799
[AGENT][POSITIVE] OK, [PII], thank you. Give me a couple of moments to get the member's information pulled up please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Maybe
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Um, um.
[AGENT][NEUTRAL] Oh goodness, OK, I'm sorry I misheard the policy number. Give me just one moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] You said 023-31799, is that correct?
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so again, any information provided would be a verification benefits and not a guarantee of payment. What is her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so thank you. The policy number that you gave me is an old policy. Is this for um a future data service?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It is for um Thursday mhm.
[AGENT][NEUTRAL] OK, so the policy number you gave me termed 51 of 2024.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] She does have another policy.
[AGENT][NEUTRAL] That is active and give me a moment to give you that information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The other policy number is 02493351.
[AGENT][NEUTRAL] And it has an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and just a moment.
[AGENT][NEUTRAL] And [PII], while this other information is loading, you do know, I'm sorry, [PII], you do know that um with this type of policy that we must also have a copy of a primary insurance company's explanation of benefits along with the claim for review.
[AGENT][NEUTRAL] And then we do have our portals that claim status can be checked in and the EOBs for APL be printed from by going to [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on this policy, she has an outpatient benefit max of $6800 per covered person per calendar year.
[AGENT][NEUTRAL] For covered outpatient services and there is a $1500 per cover person per calendar year outpatient deductible on the supplemental policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Is there a co-insurance for this one?
[AGENT][NEUTRAL] This is a supplement. No, ma'am, we are not a major medical insurance, correct.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And is there anything else, [PII], that I can help you with today?
[CUSTOMER][POSITIVE] All right perfect.
[CUSTOMER][NEUTRAL] I think that's it for now.
[AGENT][POSITIVE] OK. Well, thank you so much then for calling APL. I hope you have a very nice day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Yes, ma'am, and thank you as well.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] bye bye.