AccountId: 011433970860
ContactId: 4fc0c291-6123-47ff-960f-2a643dc29b4a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180639 ms
Total Talk Time (AGENT): 67074 ms
Total Talk Time (CUSTOMER): 66457 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/4fc0c291-6123-47ff-960f-2a643dc29b4a_20250221T14:21_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, I'm just needing help with the patient's um eligibility and benefits.
[AGENT][NEUTRAL] OK. May I ask who's calling?
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it's 01792144.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And you were just needing benefits?
[CUSTOMER][NEUTRAL] Uh, yes, please, and then just the effective date of the plan as well.
[AGENT][NEUTRAL] OK, I can give that to you. The effective date is [PII].
[AGENT][NEUTRAL] The policy is active.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Oh, I'm so sorry. I do need the benefits for like physical therapy or outpatient services um I'm not sure how it would be listed.
[AGENT][NEUTRAL] OK, for outpatient.
[AGENT][NEUTRAL] OK, any benefits given over the phone is not a guarantee of payment. This policy coordinates with the primary insurance. Whatever the primary applies to their deductible, co-pay or co-insurance only for outpatient, we'll pay up to $5000 per calendar year.
[CUSTOMER][POSITIVE] OK, perfect, covered up to $5000 and are you able to see accumulations for that?
[AGENT][NEUTRAL] Yes, ma'am. Hold on just a moment.
[AGENT][NEUTRAL] She hasn't used any.
[CUSTOMER][NEUTRAL] OK perfect and then just to make sure it's covered at 100% up to that 5000, is that correct? And they don't need to meet any deductible with you guys or anything like that?
[AGENT][NEUTRAL] No, ma'am. Only whatever their primary applies to their deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK perfect and then do they need any authorization?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][POSITIVE] OK. Thank you so much. And if I could just get a reference number, I should be all set.
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too. Bye.