AccountId: 011433970860
ContactId: 68bf17ad-1394-457c-a091-c14229223807
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 123879 ms
Total Talk Time (AGENT): 66611 ms
Total Talk Time (CUSTOMER): 40969 ms
Interruptions: 0
Overall Sentiment: AGENT=2.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/68bf17ad-1394-457c-a091-c14229223807_20250528T15:33_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] Hi, I am needing to get eligibility and benefits for a patient please.
[AGENT][POSITIVE] OK, I can assist you with both the eligibility and benefits. May I have your name and a good contact number?
[CUSTOMER][NEUTRAL] My name is [PII] and the callback number is [PII].
[AGENT][NEUTRAL] Thank you, and [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] The policy number is 02137763.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] This is for [PII]. The date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] This would be benefits for outpatient physical therapy in the office setting.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So for outpatients, the policy will pay up to $500 per calendar day. Um, so the policy itself doesn't have any in-office um coverage, but she does have the office treatment rider, so any treatment in the office as long as it's not cosmetic, could be covered up to that $500 per day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And are there any um limitations on the number of visits or any kind of authorization that's required?
[AGENT][NEUTRAL] No, um, because we're not the major medical and there's no limit on the visits, it's just up to that dollar amount per day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right well thank you so much I appreciate your help.
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] No, that's gonna be it.
[AGENT][POSITIVE] Alright, thanks for calling APL and I hope you have a great day, [PII].
[CUSTOMER][POSITIVE] Thank you you too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.