AccountId: 011433970860
ContactId: 69266802-98eb-48c5-9a85-9bc989ddec2c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206910 ms
Total Talk Time (AGENT): 103579 ms
Total Talk Time (CUSTOMER): 56637 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/69266802-98eb-48c5-9a85-9bc989ddec2c_20250114T13:57_UTC.wav
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[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Pinecrest Physical Therapy South. I'm trying to check a physical therapy benefit for a patient.
[AGENT][NEUTRAL] I'm so sorry. What was your name? I did not understand you.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII], OK. And you're needing to check physical therapy benefits for outpatients remember?
[CUSTOMER][POSITIVE] Correct, yes ma'am.
[AGENT][POSITIVE] Yes, I can help you with that. And [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and what is the member's policy number please?
[CUSTOMER][NEUTRAL] 1372646 M as in Mary, L as in Lima 8.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] OK, and again, [PII], any information I provide today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] First name [PII], last name [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Do you also need eligibility on him or strictly just benefit information, [PII]?
[CUSTOMER][NEUTRAL] Uh, strictly just benefit information and maybe when the effective date began. Other than that it'll just be.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the he is the spouse of the subscriber of the supplemental policy and the supplemental policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] MRI
[AGENT][NEUTRAL] And he has an outpatient benefit maximum per calendar year for covered outpatient services of $5000.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And there is no outpatient deductible per covered person per calendar year.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And also on these policies, Romeo, for the type of coverage he has, we will also have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then we do have a portals that our claim status can be checked in with APL by going to [PII].
[CUSTOMER][NEUTRAL] And can I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect, can I get a reference call number please?
[AGENT][NEUTRAL] My name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] Got you, and can you remind me your name please?
[AGENT][NEUTRAL] Again, my name is [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much, [PII] take care and you have a great day.
[AGENT][POSITIVE] OK. Well, you're very welcome. Yes, sir. I hope you have a great day as well and thank you again for calling APL.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you alright bye.
[AGENT][NEUTRAL] Bye.