AccountId: 011433970860
ContactId: 67c00c04-dd1d-473e-a917-a0a02bb56990
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 728840 ms
Total Talk Time (AGENT): 326909 ms
Total Talk Time (CUSTOMER): 103708 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/67c00c04-dd1d-473e-a917-a0a02bb56990_20250605T18:21_UTC.wav
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[AGENT][POSITIVE] Good morning or good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from Excel Rehab and Sports. I need to verify benefits for physical therapy done in the office, please.
[AGENT][NEUTRAL] OK, and you said your name is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and you're needing to verify benefits and eligibility for physical therapy in an office setting. Is that correct? Yes, ma'am, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] D like David 43733396
[AGENT][NEUTRAL] OK, thank you. Now [PII], that is not an APL number that is for 90 degree benefits or IMA. Were you trying to reach 90 degree benefits?
[CUSTOMER][NEUTRAL] No, they've got it in here as American.
[AGENT][NEUTRAL] Or a pill.
[AGENT][NEUTRAL] OK, so there would be another, there's another number, um, if they have an APO policy.
[CUSTOMER][NEUTRAL] APL.
[AGENT][NEUTRAL] There will be another number on their ID card for us or if you have the subscribers full social I can try and see if they indeed have a policy with APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I did not.
[AGENT][NEUTRAL] And on their ID card, does it mention APL at all?
[CUSTOMER][NEUTRAL] We don't have the card, we just have the referral.
[AGENT][NEUTRAL] And no social. I can try by the name [PII]. I can't search my date of birth, but I can try by the name.
[AGENT][NEUTRAL] To see if I can locate. If it's a real common name, well, that may be like a needle in a haystack, but we'll give it a go.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The last name is, but the first name definitely is not. The first name is.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], it's [PII]
[AGENT][POSITIVE] Thank you. And the last name?
[CUSTOMER][NEUTRAL] Last name is [PII]
[AGENT][NEUTRAL] All right, well, just a moment and let's see if we can find a member by that name.
[AGENT][NEUTRAL] And what phone number did Carry did you call in today to reach me just out of curiosity?
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] Mhm, that's our number. And the reason I'm asking that for 90 degree benefits for that the number that you gave me, their phone number, depending on which option you select, it'll either take you to 90gre Benefits or APL and a lot of people just press the wrong option. So, but give me just a moment. She does, I think I've located a policy.
[AGENT][NEUTRAL] For her with us.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Oh we're back to searching again so just a moment.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] It's still trying to load some information for me.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], how do you spell your name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and that's how I spelled it, so.
[AGENT][NEUTRAL] How long is that there today? Mhm.
[AGENT][NEUTRAL] OK, so any information [PII] that I do provide is a verification of benefits and not a guarantee of payment. What is her date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do see that she, I did look at a policy for her and she is a subscriber on this hospital indemnity limited benefit plan.
[AGENT][NEUTRAL] The correct policy number that you should have for this policy with APL is 02.
[AGENT][NEUTRAL] 61
[AGENT][NEUTRAL] 7334.
[AGENT][NEUTRAL] And it has an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, again, this is not major medical insurance, it's a limited benefit plan. So on this policy, there's not specific, is she being billed for an office visit or for just the treatment?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I know they bill an office visit for like the the eval and the ree valves, but I think it's just treatment otherwise.
[AGENT][NEUTRAL] OK. So on this plan, there's only benefits for the visit.
[AGENT][NEUTRAL] OK, um, on this on this limited benefit plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The outpatient sickness.
[AGENT][NEUTRAL] And bear with me just a second while it's trying to pull my information in.
[AGENT][NEUTRAL] OK, so on this limited benefit plan, she has an outpatient sickness rider with a maximum benefit per visit of $75.
[AGENT][NEUTRAL] And a maximum of 5 visits per calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have the correct address for claims for her policy?
[CUSTOMER][POSITIVE] That's a very good question. Let's see.
[AGENT][NEUTRAL] I can certainly give it to you if you don't.
[CUSTOMER][NEUTRAL] We, we.
[CUSTOMER][NEUTRAL] Yes, yes, please. Um, well, well, what we have is, uh, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No. No. Well, that is APL's address, but for the type of policy she has. So, this policy is multifaceted. It's actually, the claims are going to be sent through IMA first.
[CUSTOMER][NEUTRAL] Uh, OK.
[AGENT][NEUTRAL] So the claims need to be mailed to [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], which is [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] And their payer ID if you need that is 64556.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Now once the claim has been received by APL and processed, we do have a portal in which you should be able to check claim status in [PII] and the website for our portal is located at secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK. And then any questions related to that D number? Because I don't know what type of benefits she might have with them.
[AGENT][NEUTRAL] The phone number for for IMA over 90 degree benefits is [PII].
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEGATIVE] But it totally just went out of my head. OK, [PII] option one.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And if you would like, I can connect you. Yeah, sure, but you would use my name along with today's date.
[CUSTOMER][NEUTRAL] And can I get a reference number, please?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And how do you spell yours, [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Perfect. Thank you so much.
[AGENT][NEUTRAL] Well, you're very welcome. So would you like for me to connect you to [PII] to see if she has any additional benefits with them as well with the 90, OK, so again, should we get disconnected, call that that [PII] number I just gave you and select option one because option two would bring you back here.
[CUSTOMER][NEUTRAL] Uh yes, please.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK. Was there anything else, [PII], I can help you with? Oh, you're welcome.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][POSITIVE] OK. Well, thank you again for calling APL. It's my pleasure in speaking to you and I hope you have a nice afternoon.
[CUSTOMER][POSITIVE] Thank you. You too, [PII].
[AGENT][NEUTRAL] Uh, thank you. So, one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you for calling 90 Degree Benefits. The ads if you would like to participate, all agents are currently.