AccountId: 011433970860
ContactId: 78ea4eac-49ea-4fc9-9077-cbebfff92127
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 307279 ms
Total Talk Time (AGENT): 75586 ms
Total Talk Time (CUSTOMER): 204388 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/78ea4eac-49ea-4fc9-9077-cbebfff92127_20250618T14:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is Mo[PII]How may I help you?
[CUSTOMER][NEUTRAL] P
[CUSTOMER][NEUTRAL] Hi Mo[PII]My name is So[PII]How are you?
[AGENT][POSITIVE] I'm great. How are you?
[CUSTOMER][NEUTRAL] Great, thank you. I have a quick question. Um, so I was wondering, I'm trying to process a claim, um, to my gap insurance for physical therapy. Um, my question to you is, I had to submit it to my primary insurance, um,
[CUSTOMER][NEUTRAL] Uh, let me start, let me start from the beginning because it's a little complicated. So I gave birth in March, in April they recommended that I start physical therapy. Um, I went to the initial consultation, um, and basically I processed that, uh, claim to my insurance, which they're still working through.
[CUSTOMER][NEUTRAL] After the initial consultation, the physical therapist recommended that I get a package of 6 visits, um, and I have not processed that through my primary insurance because my primary insurance, my coverage ended at the end of April and this started Ma[PII].
[CUSTOMER][NEUTRAL] So I went to my new insurance to try to process that, and they basically told me that I need to process it through my old insurance based on the date of conception because this physical therapy is due to a pregnancy-related uh situation.
[CUSTOMER][NEUTRAL] Um, I'd like to process it through my gap insurance to see if you guys would be able to cover it. Um, the only thing is that my coverage ended with because I left my employer, my coverage was through the end of April, and this was purchased Ma[PII]Is there any way that I can still process it through you guys, um.
[CUSTOMER][NEUTRAL] Because again, like the, the, my primary insurance mentioned this physical therapy is due to a pregnancy related item which is when I was um insured by you guys.
[AGENT][NEUTRAL] May I have your policy number and I'll get your policy pulled up.
[CUSTOMER][NEUTRAL] Yes, um, do you need my group num my payer ID or my group number?
[AGENT][NEUTRAL] It should say inpatient or outpatient cert number.
[CUSTOMER][NEUTRAL] Oh, the outpatient benefit certification number, yes, it's 02517.
[CUSTOMER][NEUTRAL] 189 M as in Mary, L as in Larry 8.
[AGENT][POSITIVE] Thank you. May I have a good callback number for you?
[CUSTOMER][NEUTRAL] Yes, 30[PII].
[CUSTOMER][NEUTRAL] 52[PII].
[AGENT][NEUTRAL] Thank you. Can you verify your date of birth, your mailing address, and your email, please?
[CUSTOMER][NEUTRAL] 10[PII]My mailing address is 80[PII]nd my email address is SO[PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. So with this plan, it does follow your primary. Were there any physical therapy charges prior to 51 of 25?
[CUSTOMER][NEUTRAL] Yes, there was.
[AGENT][NEUTRAL] OK. So, as long as you have the primary insurance EOB, yes, you can submit those.
[CUSTOMER][NEUTRAL] OK, so it has to be prior to 51 then.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Because the, so basically 424 is when I went to my initial consultation at that I have that I paid $250 so I'll process that um after that at that session they recommended that I do a package of 6, but it was charged on my credit card Ma[PII].
[CUSTOMER][NEUTRAL] Um, and my prime, my new primary insurance basically said that I had to go to my prior insurance because, because this is a pregnancy related physical therapy need, um, they have to go by the date of the initial conception, which is when I was with you guys.
[AGENT][NEUTRAL] OK. So, yes, ma'am. As long as we have the primary.
[CUSTOMER][NEUTRAL] Does that makes sense.
[AGENT][NEUTRAL] They should be able to allow these up until
[AGENT][NEUTRAL] 51[PII]Sometimes they do have that thirty-day grace period.
[CUSTOMER][NEUTRAL] So yeah this was charged Ma[PII].
[AGENT][NEUTRAL] OK, yes, sometimes they do allow that grace period on these plans.
[CUSTOMER][NEUTRAL] OK, so I'll just
[CUSTOMER][NEGATIVE] I'll just start with the 42[PII]ecause the, the 55 hasn't even been processed to my my primary insurance.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I just uploaded like I usually do with my um EOB and all that?
[AGENT][NEUTRAL] And do you have
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][POSITIVE] OK perfect I'll do it online then.
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] So[PII]thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][POSITIVE] Thank you you too. OK bye bye.