AccountId: 011433970860
ContactId: 69dfd7cc-fbe9-469e-b5e8-20189a71012c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235509 ms
Total Talk Time (AGENT): 93239 ms
Total Talk Time (CUSTOMER): 58159 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/69dfd7cc-fbe9-469e-b5e8-20189a71012c_20250124T14:45_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][POSITIVE] Hi thank you so much can
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Hi, I'm calling to get benefits for physical therapy and occupational therapy in an office setting.
[AGENT][NEUTRAL] OK, may I ask who's calling?
[CUSTOMER][NEUTRAL] Say that one more time, you got cut out.
[AGENT][NEUTRAL] May I ask who's calling?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] 024.
[CUSTOMER][NEUTRAL] 54266 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And his date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you were just needing benefits for physical therapy and occupational therapy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can help you with that. The effective date is [PII]. Any benefits given over the phone is not a guarantee of payment. Occupational therapy is not covered. Physical therapy is covered. It coordinates with the primary insurance, whatever the primary applies to their deductible, co-pay or co-insurance only will pay up to $750 per calendar day.
[CUSTOMER][NEUTRAL] 700 and what I'm sorry?
[AGENT][NEUTRAL] $750 per calendar day.
[CUSTOMER][NEUTRAL] OK, will you guys cover the deductible of the primary or no?
[AGENT][NEUTRAL] Right, it coordinates with the primary. We only pick up deductibles, co-pays, or co-insurance.
[AGENT][NEUTRAL] Up to that 750.
[CUSTOMER][NEUTRAL] Is there a deductible out of pocket for this plan?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] No co-payment either, right?
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] It just mirrors the major medical.
[CUSTOMER][NEUTRAL] And what kind of plan is this?
[AGENT][NEUTRAL] This is a Middle gap policy.
[CUSTOMER][NEUTRAL] OK, can I get your first name, last name, initial, and possibly a reference number?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date. My name is [PII] My last initial is [PII]
[CUSTOMER][NEUTRAL] And just before we hang up, can you verify this? do you guys require pre-certification or authorization?
[AGENT][NEUTRAL] No, ma'am, we do not.
[CUSTOMER][POSITIVE] OK beautiful thank you so much for your help. Have a lovely day and the weekend, OK?
[AGENT][POSITIVE] Thank you, [PII], for calling APO you as well.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.