AccountId: 011433970860
ContactId: 7100aa36-caf9-40b4-8092-b9b43a4373d8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 427700 ms
Total Talk Time (AGENT): 181053 ms
Total Talk Time (CUSTOMER): 190952 ms
Interruptions: 3
Overall Sentiment: AGENT=0.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/7100aa36-caf9-40b4-8092-b9b43a4373d8_20250512T16:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, uh, this is [PII]. Good morning. How are you?
[AGENT][POSITIVE] I'm doing good. How about you?
[CUSTOMER][NEUTRAL] Mm, fine. OK. I want to know if my insurance covers um
[CUSTOMER][NEUTRAL] The copay for.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Physical therapist.
[AGENT][NEUTRAL] OK. May I have your policy number?
[CUSTOMER][NEUTRAL] Yeah, my policy number is
[CUSTOMER][NEUTRAL] Mm group the group then the group number?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] The outpatient benefit certification number.
[CUSTOMER][NEUTRAL] OK, perfect. 002185085.
[CUSTOMER][NEUTRAL] M as in Martha, L as in Laura, and H.
[AGENT][NEUTRAL] And could you verify your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And I do need to verify your mailing address listed on file.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, so for that email that's not the one that we have listed on file.
[CUSTOMER][NEUTRAL] My
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, this is my email. Yeah, because I have to, I, I in charge to pay the invoices in, uh, in the company, but I don't know if maybe like my, my email company [PII], but I never received uh.
[AGENT][NEUTRAL] Oh, OK, I thought you were saying, I apologize. I thought you were saying a word when you say MDS I thought it was a word. I do apologize. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and may I please have a callback number?
[CUSTOMER][NEUTRAL] Uh my cell phone [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] That is my, my phone number, but you, you want the company phone number?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] No, I was just needing a call back number just in case the call is disconnected.
[CUSTOMER][POSITIVE] OK, perfect. Thank you very much.
[AGENT][NEUTRAL] You're welcome and you were calling to see if something was covered up under your plan?
[CUSTOMER][NEUTRAL] Yes, I want to, I, uh, my plan, um, my physical therapist is telling me that um they are going to charge $50 for uh a copay, but I don't know if.
[CUSTOMER][NEUTRAL] APM covers, so the gap covers that kind of.
[CUSTOMER][NEUTRAL] Of expenses.
[AGENT][NEUTRAL] OK. And this is for physical therapy treatment?
[CUSTOMER][NEUTRAL] Yes, physical therapist treatment, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me pull that up for you and thank you so much [PII] for verifying your policy. You're calling in for physical therapy benefits verification of coverage does not guarantee the payment of the claim.
[AGENT][NEUTRAL] For physical therapy, you do have up to $1000 per calendar year that will go towards the primary insurance deductible, co-insurance, or co-pay. This policy is for sickness and injury. It does not cover any preventative or wellness. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But then, OK. You don't, the, the, the, the policy doesn't cover?
[AGENT][NEUTRAL] It covers up to $1000 per calendar year.
[CUSTOMER][NEUTRAL] OK, then can I, can I send you uh the invoice that they charged me, or?
[CUSTOMER][NEUTRAL] Because the, because the total of the treatment is going to be uh like uh.
[CUSTOMER][NEUTRAL] 5 therapies in like uh $5500.
[AGENT][NEUTRAL] OK. So have they already have they already started the services or is this just a pre-treatment?
[AGENT][NEUTRAL] That they're, they give you.
[CUSTOMER][NEUTRAL] No, they, they start the services on Friday.
[AGENT][NEUTRAL] OK. So, you would have to get your pump.
[CUSTOMER][NEUTRAL] On Friday, Friday, I pay, I pay to them.
[AGENT][NEUTRAL] OK, so what you would have to do, you will have to wait until your primary insurance, which is your, whoever is your primary, they will have to process the claim first. Once they process the claim, you will get an EOB showing what was your responsibility which was applied for your deductible coinsurance or co-pay. Once you get that.
[CUSTOMER][NEUTRAL] Mhm. Exactly.
[AGENT][NEUTRAL] Then you can submit that over to us with the diagnosis code for the services from the provider. And once we receive that, then we will review that claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh, OK. OK. Excellent. Perfect.
[AGENT][NEUTRAL] Cause we, we can't do anything until your primary insurance processes it.
[CUSTOMER][NEUTRAL] I'm going to do.
[CUSTOMER][NEUTRAL] Yeah, no, they process the, the, the, the con, so they, they cover it, but they charge me, uh, $50 per visit.
[AGENT][NEUTRAL] Yes, so once your primary insurance, the, if you just had the services rendered Friday.
[AGENT][NEUTRAL] Then they have the provider that you went to will have to send it to whoever your primary insurance is.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It may take them some time to process it, so once you receive that EOB for that data service, then you can submit the information in.
[CUSTOMER][POSITIVE] Perfect. OK
[CUSTOMER][NEUTRAL] No
[CUSTOMER][POSITIVE] Perfect, perfect, perfect, perfect. OK, OK, excellent. And do you have an email with, or in the case that I send the, the, the bill or the the EOB?
[AGENT][NEUTRAL] The way that you will submit it is either that secured portal that is listed on the card, the fax number, or the mailing address.
[CUSTOMER][NEUTRAL] Ah, OK.
[CUSTOMER][POSITIVE] Perfect. OK. Yes, here is [PII]. OK, perfect. Thank you very much.
[AGENT][NEUTRAL] Yes, now if you haven't accessed that portal, if you hadn't accessed that portal before, you will have to set up a username and password to get into that portal.
[CUSTOMER][POSITIVE] OK. OK. Perfect.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, thank you very much. Everything is fine. Thank you.
[AGENT][POSITIVE] You're, you're welcome. Thank you for calling American Public Life. Have a great day.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye bye.