AccountId: 011433970860
ContactId: 3fde29da-6d3e-4b12-8626-35b8f5e63a94
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 154800 ms
Total Talk Time (AGENT): 74053 ms
Total Talk Time (CUSTOMER): 71089 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/3fde29da-6d3e-4b12-8626-35b8f5e63a94_20250310T16:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Pros office to check on the patient's benefits.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with benefits. Um, first, I'll need to go callback number.
[CUSTOMER][NEUTRAL] Oh yes. It's gonna be [PII], no extension.
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Mhm. It's gonna be
[CUSTOMER][NEUTRAL] 02507924 M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] Can you please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yes, [PII] of [PII].
[AGENT][NEUTRAL] OK. And do you need to verify benefits or check on the status of the claim?
[CUSTOMER][POSITIVE] Benefits, please.
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, I'm showing the effective date on this policy was [PII] and the policy is still active. Um, is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Out, outpatient benefits and it's, it's gonna be for the physical therapy benefits, physical therapy evaluation, outpatient.
[AGENT][NEUTRAL] OK, for physical therapy, um, that's covered under the outpatient benefit and we cover up to 3500 per calendar year. And that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes declined.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. The uh the patients as a primary insurance of AllMed, uh, patients co-pay will be covered, covered by the secondary, right? $80 will be covered by the secondary, right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] Thank you so much, ma'am. Um, you said $3500 is for the lifetime maximum or the individual deductible? Is the lifetime maximum? What?
[AGENT][NEUTRAL] No, it's for the calendar year.
[CUSTOMER][NEUTRAL] OK. Uh, total 3500 will be covered, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Thank you, thank you. OK. Can I get your name one more time and the call the first number?
[AGENT][NEUTRAL] The reference number is my name on today's date. My name is [PII]. It's spelled [PII] My last initial is [PII]
[CUSTOMER][NEUTRAL] He and
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] My
[AGENT][NEUTRAL] Yeah, and my name and today's date is the um reference number. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] Uh, no, no, that's it for me and have a nice day. Thank you for. Have a nice day. Bye.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][NEUTRAL] Bye.