AccountId: 011433970860
ContactId: 579410d1-3f78-407e-bd6a-b564c42d04ec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251809 ms
Total Talk Time (AGENT): 119111 ms
Total Talk Time (CUSTOMER): 71132 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/579410d1-3f78-407e-bd6a-b564c42d04ec_20250114T16:04_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Yes, I need to get outpatient hospital based physical therapy benefits on a patient, please.
[AGENT][NEUTRAL] OK, yeah, I can look at those outpatient physical therapy benefits for you my friend. Do you have?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I'm so sorry, do you mind if I get your name and a good call back number real quick?
[CUSTOMER][NEUTRAL] Sure it's it's [PII] and it's [PII] and that's direct.
[AGENT][POSITIVE] Wonderful, and your member's policy number?
[CUSTOMER][NEUTRAL] It is 226-594-6.
[CUSTOMER][NEUTRAL] See you later.
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Let's see. Would you be able to verify for me, pretty please, your patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII] [PII].
[AGENT][POSITIVE] Awesome, and 1 2nd.
[CUSTOMER][NEUTRAL] question
[AGENT][NEUTRAL] All right, I do have an updated policy number for Ms. [PII], if you would like to take it.
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] OK, sure
[AGENT][POSITIVE] Perfect. I have the policy number as 2556231.
[CUSTOMER][NEUTRAL] 2556231
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, we do have an outpatient benefit of, let me make sure that's not combined real fast, one second. Oh no, it's not, um, she has an outpatient benefit of $8150 for outpatient services.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I do want to let you know any benefit information I give you over the phone. It's just the verification of coverage number guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And was there any other benefit information you would need today, my friend?
[CUSTOMER][NEUTRAL] Oh, OK, um, is there any, so there's no visit limitations or anything you just cover.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Um, whatever her primary doesn't cover.
[AGENT][NEUTRAL] Yeah, we try to pick up and pay on the co-pay, coinsurance and deductible for accident injury, sickness.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And does she have an out of pocket or anything or it's just mainly the outpatient services as 8150?
[AGENT][NEUTRAL] Uh, that's it, yeah. We just have that benefit listed on here for her. No deductibles or anything on our side.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is her uh effective date please?
[AGENT][NEUTRAL] Oh, I'm sorry, yes, let me go back to that for you, my friend. I have the effective date listed as.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, is there a group number to this policy, or is it just mainly a policy ID?
[AGENT][NEUTRAL] Uh, there is a group number if you need it. I have 22517.
[CUSTOMER][NEUTRAL] OK, and the claims mailing address please?
[AGENT][NEUTRAL] Yeah, you betcha. We're gonna go to [PII]. That's gonna be here in [PII] City, [PII], I'm sorry, [PII].
[CUSTOMER][NEUTRAL] Can you say that again? [PII].
[AGENT][NEUTRAL] [PII]. I said it wrong the first time. I'm sorry, miss.
[CUSTOMER][NEUTRAL] Oh, you're fine. OK, [PII], is there a reference number for the call then?
[AGENT][NEUTRAL] You bet you it's gonna be my name [PII], first initial last name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK perfect thank you very much I appreciate your help.
[AGENT][POSITIVE] Hey, it's my pleasure. Thank you for calling APL and I hope you have a fabulous day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] You too thanks bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.