AccountId: 011433970860
ContactId: 48aae8f6-77ee-4dde-a3a2-2cf4ef28f81b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 302000 ms
Total Talk Time (AGENT): 164805 ms
Total Talk Time (CUSTOMER): 88305 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/48aae8f6-77ee-4dde-a3a2-2cf4ef28f81b_20250115T19:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling from Select Physical Therapy. I need to confirm whether or not a patient has PT benefits, please.
[AGENT][NEUTRAL] OK, I can help you with PT benefits, [PII]. What is your callback number, please?
[CUSTOMER][NEUTRAL] [PII], no extension.
[AGENT][NEUTRAL] OK thank you and what's the patient's name?
[CUSTOMER][NEUTRAL] It is [PII], that's [PII]
[AGENT][NEUTRAL] OK, and then [PII]'s date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And her policy number?
[CUSTOMER][NEUTRAL] Um, we have H A as in apple, 6482.
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Um, let me see if I can see if we have a policy for her at all under the name.
[CUSTOMER][NEUTRAL] OK, I was thinking that was probably the group number that they gave.
[CUSTOMER][NEUTRAL] Versus the policy number.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, um, [PII] and it's [PII] Is that correct?
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Correct, yes, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes. And date of birth is [PII]. OK, good. I have found, I have found her.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so, um,
[AGENT][NEUTRAL] Her effective date is [PII].
[AGENT][NEUTRAL] And this is just to verify her coverage is not a guarantee of payment. She has a supplemental insurance policy that helps with deductible, co-pay and co-insurance. I'm going to look to see, I'm gonna actually pull up her um policy to see if there's anything in there that states physical therapy.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's gonna be just a second because it's gonna have to download the policy for me to be able to read it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, are you um able to give me the correct policy number?
[AGENT][POSITIVE] Absolutely. I'm so sorry. I should have already done that for you. Um, it is 205.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 9445.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][POSITIVE] Thank you my love I appreciate it.
[AGENT][POSITIVE] You're very welcome. OK, let's see what it says here.
[CUSTOMER][NEUTRAL] You.
[AGENT][NEUTRAL] We always have to look at these policies because some of them have them and some of them don't, so.
[CUSTOMER][NEUTRAL] Oh trust me, I know. I tell the patients all the time what they, what about the gap policy, but do you have physical therapy coverage?
[AGENT][NEUTRAL] Right. Some of them that actually says and then some of them, it doesn't, if it's not on there, then it's not covered. So, I, I always pull them every time just to make sure cause that is.
[CUSTOMER][POSITIVE] It it matters.
[CUSTOMER][POSITIVE] Exactly.
[CUSTOMER][POSITIVE] Exactly.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] That can be a thorn in our side for sure, if we don't look.
[CUSTOMER][POSITIVE] Yes, yes, yes.
[AGENT][NEUTRAL] OK. Keep scrolling.
[AGENT][POSITIVE] I've actually kind of learned it in a way where they're actually located at too somewhat.
[CUSTOMER][NEUTRAL] Save you some time, go straight to it.
[AGENT][NEUTRAL] OK. She does have physical therapy in an office center or clinic in which a licensed physical therapist provides physical therapy.
[CUSTOMER][NEUTRAL] OK, and what's the dollar amount that they'll cover up to?
[AGENT][NEUTRAL] Uh, so it goes under her outpatient benefits and let me see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] She has outpatient calendar year benefit amount of $4000 per calendar year.
[CUSTOMER][NEUTRAL] And she hasn't used any of the benefits so far, correct?
[AGENT][NEUTRAL] Let me check for you.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Just give me just a sec.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] No, nothing has been used this year.
[CUSTOMER][POSITIVE] Beautiful. That works, my love. Can I get a call reference number please?
[AGENT][NEUTRAL] Yes, ma'am. You can use my name in today's date.
[CUSTOMER][NEUTRAL] And that's [PII]?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][POSITIVE] Oh, [PII], I, I don't know why I thought I heard [PII]. All right, Ms [PII], thank you very much. I appreciate your time and help.
[AGENT][NEUTRAL] That's OK.
[AGENT][POSITIVE] OK, you have a blessed day, Ms. [PII]. Thank you so much for calling APL.
[CUSTOMER][POSITIVE] Absolutely bye bye.
[AGENT][NEUTRAL] Mm bye-bye.