AccountId: 011433970860
ContactId: 3c93744c-cb28-4c7e-b82e-25ef9dc7336a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225750 ms
Total Talk Time (AGENT): 104357 ms
Total Talk Time (CUSTOMER): 36646 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=2.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/3c93744c-cb28-4c7e-b82e-25ef9dc7336a_20250206T15:04_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] Hi, my name is [PII]. I was calling to see um eligibility and benefits for a patient for physical therapy services.
[AGENT][NEUTRAL] OK, [PII], you're needing physical therapy and excuse me, eligibility and physical therapy information, benefit information?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, ma'am, I can help you with those things. And what is a good callback number for you first off, please, [PII]?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] Yeah, that is 02462882.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] OK, and any information that I provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth, please?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do show that she is the subscriber on the supplemental policy. It is active with an effective date of [PII].
[AGENT][NEUTRAL] And she has an outpatient benefit max of $7500 per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And there is no outpatient deductible per covered person per calendar year.
[AGENT][NEUTRAL] And again this is the benefit max is $7500 for covered outpatient services and because this is a supplemental policy, [PII], to her primary insurance, when the claim is submitted to APL for review, we must also have a copy of her primary insurance company's explanation of benefits.
[AGENT][NEUTRAL] And then once we have processed our claim here at APO we do have a portal that you should be able to check claim status in by going to secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And is there anything else, [PII], that I can help you with?
[CUSTOMER][NEUTRAL] That is all I needed. If you have a reference number for this phone call, I will take that.
[AGENT][POSITIVE] Yes ma'am, you're gonna use my name along with today's date.
[CUSTOMER][POSITIVE] All righty.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. Thank you very much for your help.
[AGENT][POSITIVE] Well, you are certainly very welcome. So thank you again for calling APL and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you too. Mm bye.
[AGENT][POSITIVE] Thank you, bye-bye.