AccountId: 011433970860
ContactId: 44db37aa-4a27-4f18-bbee-8bac80844cee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 312869 ms
Total Talk Time (AGENT): 95957 ms
Total Talk Time (CUSTOMER): 104492 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/44db37aa-4a27-4f18-bbee-8bac80844cee_20250114T15:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Um, yeah, my name is [PII] calling with the provider's office. I'm verifying benefits for one of our patients.
[AGENT][NEUTRAL] OK, spell your first name for me.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] I have 60, 80, and then 1.
[AGENT][NEUTRAL] That's the payer ID number. If you have the card, it's gonna be the policy er number that begins with a 0.
[CUSTOMER][NEUTRAL] Uh, no, I don't.
[AGENT][NEUTRAL] Spell the patient's first and last name?
[CUSTOMER][NEUTRAL] Uh first name [PII].
[CUSTOMER][NEUTRAL] Uh last name [PII].
[AGENT][NEUTRAL] OK. And is this for service in a doctor's office?
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] OK, and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] and no extension.
[AGENT][NEUTRAL] OK. And what state does the patient reside?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] What state does the patient reside?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah, [PII]. We're, we're located in [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And verify the patient's um date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for that. Let me give you the policy number. Let me know when you're ready.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] That number is 248.
[AGENT][NEUTRAL] 1560.
[AGENT][NEUTRAL] I show the policy effective date of [PII]. Policy is active at this time.
[AGENT][NEUTRAL] And under this policy, the physician visit fee is not covered.
[AGENT][NEUTRAL] Um, there is an office treatment rider under the policy, so covered treatment can be considered under the policy.
[CUSTOMER][NEUTRAL] Oh, I'm, I'm looking to check, uh, chiropractic By done in office settings.
[AGENT][NEUTRAL] OK, what type of service?
[AGENT][NEUTRAL] What's being done?
[CUSTOMER][NEUTRAL] Uh, chiropractic.
[AGENT][NEUTRAL] Mhm. Specifically what's being done?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, I can give you the CPTs. I don't know if it makes any difference.
[AGENT][NEUTRAL] Is it manipulation, physical therapy?
[CUSTOMER][NEUTRAL] Uh, it's combined manipulation and physical therapy.
[AGENT][POSITIVE] Thank you
[AGENT][NEUTRAL] One moment, let me check the policy benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm still looking like one moment.
[AGENT][NEUTRAL] OK, so chiropractic services are not covered under this policy.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Or not, yeah, then I was looking uh like this is like a supplemental plan or secondary uh plan.
[AGENT][POSITIVE] Right. Correct.
[CUSTOMER][NEUTRAL] Uh, uh, Medicare Part B is inactive, so Blue Cross and Blue Shield.
[AGENT][NEUTRAL] it's not a Medicare plan. It's not Medicare, it's a Metlink plan.
[AGENT][NEUTRAL] Not Medicare.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But uh I have a quick question though because normally uh most of the plans, most of them uh with APL, American Public Life, uh, the office visit is is not covered, but I don't know if this, this is the case.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It just depends on the type of policy we have a plethora of policy, so it could be covered under one and not the other, so it just depends on the policy.
[CUSTOMER][POSITIVE] All righty. OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That, that's what I needed to know. I thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright [PII], I'm [PII], I'm sorry, any other questions?
[CUSTOMER][POSITIVE] No, that's, that's about it. Thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] You too. Thanks.