AccountId: 011433970860
ContactId: 5745a2c9-ee88-48bf-bd7d-38593b3fbf2a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 319179 ms
Total Talk Time (AGENT): 119950 ms
Total Talk Time (CUSTOMER): 89090 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/5745a2c9-ee88-48bf-bd7d-38593b3fbf2a_20250528T20:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling from Cora Physical Therapy, and I was just calling in to uh get benefits for a patient coming in for physical therapy.
[AGENT][POSITIVE] OK, I can help you with benefits. [PII]. Can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, that's [PII].
[AGENT][NEUTRAL] Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] I do. That is 02580010.
[AGENT][NEUTRAL] I have 256-0010.
[CUSTOMER][NEUTRAL] Um, I'm just gonna double check. It's a bit blurry on my end. I have it as 02580010.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. I think it broke up a little bit, so I couldn't, I couldn't quite hear. So let me look that up real quick.
[AGENT][NEUTRAL] OK. And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you so much for verifying that with me.
[AGENT][NEUTRAL] I will say that I am showing this as our Medlink policy, which is secondary gap insurance, meaning that the primary insurance will need to cover some or partial benefits first, um, and we will need the primary insurance EOB or explanation of benefits when filing a claim for this.
[AGENT][NEUTRAL] Let me see if she has physical therapy benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Alright, and I do want to say that this is just a verification of benefits and not a guarantee of payment. It looks like [PII] has an outpatient benefit maximum of up to $500 per covered person per calendar day.
[CUSTOMER][NEUTRAL] All right. Now I just wanna uh make sure when it says per day, that means up to 500 for as long as she's coming in each time?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Um, and, uh, for this policy, it needs to be due to a sickness or accident, which it sounds like it is, but, um,
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] But it does need to be due to sickness or accident.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] And does that mean
[AGENT][NEUTRAL] Let me see real quick.
[CUSTOMER][NEGATIVE] Sorry, I just lost my train of thought.
[CUSTOMER][NEUTRAL] Um, that is for rehabilitation. I'm sorry, it's been a day.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, yes, ma'am, it should be, uh, let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, she's not just going in on her own free will. She was prescribed by a doctor to go.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, yeah, yeah.
[AGENT][NEUTRAL] So she should be good um and like I said, uh, did you want our fax or?
[CUSTOMER][POSITIVE] OK, perfect. All right.
[CUSTOMER][NEUTRAL] Sure I can go ahead and fax that over um.
[AGENT][NEUTRAL] For our payer ID?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I, she's currently in her eval now, so it may be a bit before I be I'm able to send over, um, but I'll definitely get it over to you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, is there anything else I can help you with?
[CUSTOMER][NEUTRAL] So whenever you're ready.
[CUSTOMER][NEUTRAL] No, that'll be it.
[AGENT][POSITIVE] Alright, well thank you so much for calling [PII]. I hope you have a great day.
[CUSTOMER][NEUTRAL] Of course. And do you all do reference numbers? Sorry about that.
[AGENT][NEUTRAL] Um, no, we don't do reference numbers, but you can use my name and last initial in today's date, so [PII], in today's date.
[CUSTOMER][POSITIVE] All right. Well, thank you so much again and I hope you have a great rest of your day.
[AGENT][POSITIVE] Thank you so much and have a great day.
[CUSTOMER][POSITIVE] Thanks, bye.