AccountId: 011433970860
ContactId: 56522b36-3470-4a3e-b802-704ab94829fa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176169 ms
Total Talk Time (AGENT): 92949 ms
Total Talk Time (CUSTOMER): 57145 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/56522b36-3470-4a3e-b802-704ab94829fa_20250310T21:54_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey I was calling to see if I could verify benefits on a number.
[AGENT][POSITIVE] OK, sure, I can assist you with benefits. May I have your name?
[CUSTOMER][NEUTRAL] Yes, it's [PII]
[AGENT][POSITIVE] Thank you, Ms [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number, Miss?
[CUSTOMER][NEUTRAL] 02480526
[AGENT][NEUTRAL] Thank you one moment let me pull that policy.
[AGENT][NEUTRAL] And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and the date of birth is uh [PII].
[AGENT][NEUTRAL] All right and what type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] I'm sorry, what?
[AGENT][NEUTRAL] What type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] Oh, I'm sorry. It'll be for um outpatient physical therapy. He states that he has United Healthcare as a primary, and this is secondary to his plan.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. And that is correct. This is the secondary policy. Um, let me check and see if we cover physical therapy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, and before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[AGENT][NEUTRAL] Mm, maybe one more minute. I'm waiting on the.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Be to upload.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, we do cover physical therapy facility or physical therapy, and this is gonna be subject to the outpatient maximum which is 1000 per covered person per calendar year.
[CUSTOMER][NEUTRAL] And then you said that was the outpatient?
[AGENT][POSITIVE] Yes, outpatients part of this outpatient benefit.
[CUSTOMER][NEUTRAL] OK, I'm sorry I'm sorry, out of, I'm sorry, out of pocket. I'm sorry.
[AGENT][NEUTRAL] It's, it's not gonna be out of pocket. That's gonna be the maximum benefit. So basically, if the major medical applies um any amount towards the deductible co-payment and co-insurance, we will pick up up to 1000 for the, for the year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, so just up to 1000 for the for the year.
[AGENT][NEUTRAL] For the year, for any outpatient service, including physical therapy.
[CUSTOMER][POSITIVE] OK perfect all right thank you so much for your help.
[AGENT][NEUTRAL] You're welcome. Is there anything else I can help you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] Um, no, that'll be it.
[AGENT][POSITIVE] All right. Well, thank you for calling APO. Have a good day, Ms [PII].
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thank you, doctor.