AccountId: 011433970860
ContactId: 65b77b33-27a3-4f68-89fa-e1b9f580aa69
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176100 ms
Total Talk Time (AGENT): 89258 ms
Total Talk Time (CUSTOMER): 53913 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/65b77b33-27a3-4f68-89fa-e1b9f580aa69_20250314T14:39_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. I'm calling to check on physical therapy benefits.
[AGENT][POSITIVE] OK, I can definitely help you with the physical therapy benefits. May I have your name and a good contact number?
[CUSTOMER][NEUTRAL] Sure, my name is [PII]. My direct line is [PII].
[AGENT][NEUTRAL] Thank you and [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] 02249676
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active, it's been effective since [PII], and you said physical therapy benefits.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I'm just waiting for the benefits to populate here.
[CUSTOMER][NEUTRAL] Mhm. That's OK.
[CUSTOMER][NEGATIVE] Because I had a denial and I.
[CUSTOMER][NEUTRAL] I think it says it doesn't pay for benefits, but when we verified the first time, I thought they said they did, so I'm just kind of double checking.
[AGENT][NEUTRAL] OK, well let's see, so for.
[AGENT][NEUTRAL] So for outpatient, the policy will pay up to $500 per occurrence, but
[AGENT][NEUTRAL] I don't see physical therapy on here. Hold on one. I'm just gonna make, I just wanna make sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Position.
[AGENT][NEUTRAL] Yeah, this particular policy doesn't have the um physical therapy benefits.
[CUSTOMER][NEGATIVE] So they don't have physical therapy benefits. No.
[CUSTOMER][NEUTRAL] Is that what you, is that what that meant?
[AGENT][NEUTRAL] Correct, um, this, I'm not showing physical therapy. It has outpatient where most of the time physical therapy would be, but once I go and like look into the everything that's covered, it's like emergency room, urgent care, um outpatient surgery.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But physical therapy isn't on here.
[CUSTOMER][POSITIVE] Got you. All right, is.
[CUSTOMER][NEUTRAL] All right. Is there a reference number just in case the patient asks me?
[AGENT][NEUTRAL] Sure, um, so there's no call reference number, but you can use my name in today's date and that's [PII].
[CUSTOMER][POSITIVE] Wonderful. Thank you for your help.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye. Uh-huh.
[AGENT][POSITIVE] You're welcome. Bye bye.