AccountId: 011433970860
ContactId: 3e62b743-95a6-46ca-8c72-08fa2aa9937f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 328230 ms
Total Talk Time (AGENT): 112469 ms
Total Talk Time (CUSTOMER): 122988 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/3e62b743-95a6-46ca-8c72-08fa2aa9937f_20250319T18:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII], and could you please repeat your name?
[AGENT][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] OK, so I'm calling from the provider's office to verify members eligibility and benefits.
[AGENT][NEUTRAL] May I please have a callback number?
[CUSTOMER][NEUTRAL] It's [PII]. No extension.
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] It's 02573210.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII] with the date of birth, [PII].
[AGENT][NEUTRAL] And you're calling in for eligibility and benefits, is there a specific benefit you're calling in for?
[CUSTOMER][NEUTRAL] Uh, physical therapy benefits, pleasure service office.
[AGENT][NEUTRAL] OK. And you said physical therapy benefits?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. I'm pulling that information up for you now.
[AGENT][NEUTRAL] And verification of coverage does not guarantee the payment of the claim.
[AGENT][NEUTRAL] This policy is currently active with the effective date of [PII] for outpatient, the member has up to $1000 per calendar year that will go towards the primary insurance deductible, co-insurance, or co-pay. This policy is for sickness and injury only. It will not cover any preventative or wellness. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] And what is the patient's responsibility, sir?
[AGENT][NEUTRAL] The member has up to the $1000 per calendar year that we will pay out.
[AGENT][NEUTRAL] This is not a major medical, this is a supplemental.
[CUSTOMER][NEUTRAL] OK. So you will be just paying the $1000 per calendar year and the rest of the amount will be paid by the members.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Towards the primary.
[AGENT][NEUTRAL] No, that's not what I'm saying. We're commit, we're considered their supplemental to their primary insurance. So you may need to contact their primary insurance, but we will pay up to the $1000 towards the primary's deductible, co-insurance, or co-pay.
[CUSTOMER][NEUTRAL] OK, fine. And uh what is the coordination of benefits for this like uh like this APL?
[CUSTOMER][NEUTRAL] It is a secondary insurance or the insurance?
[AGENT][NEUTRAL] That's what I stated where they're supplemental.
[CUSTOMER][NEUTRAL] Yeah, but it is a secondary or it's a tertiary?
[AGENT][NEUTRAL] OK. So we're the last resort to any insurance where there's supplemental insurance.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] OK. And uh what is the termination date? Is there any termination date of Japan?
[AGENT][NEUTRAL] It is currently active.
[CUSTOMER][NEUTRAL] And the plant die?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 3.
[AGENT][NEUTRAL] This is their supplemental.
[AGENT][NEUTRAL] What do you meaning their plan type?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, fine. I just want to summarize the details that you just give to me that the number I have an active policy effective from [PII]. No termination date plan type is supplemental plan.
[CUSTOMER][NEUTRAL] And for physical therapy, you will be paying $1000.
[CUSTOMER][NEUTRAL] What's the member's deductible and co-insurance and copy of from the primary insurance.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Does the prior authorization or referral is required?
[AGENT][NEUTRAL] No, we don't require authorization.
[CUSTOMER][NEUTRAL] OK. And uh is there any like visit limits for visit limits for physical therapy or it will be based on medical?
[AGENT][NEUTRAL] It's just a dollar amount limit.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] OK, fine. Thank you so much.
[CUSTOMER][NEUTRAL] OK. And what will be the call reference number?
[AGENT][NEUTRAL] The call reference would be my first name [PII], last initial of [PII] and today's date.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, fine. Thank you so much. Have a good day.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day as well.
[CUSTOMER][NEUTRAL] Hello