AccountId: 011433970860
ContactId: 7db46674-69cf-466f-9f45-d9fdac093d2b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 474059 ms
Total Talk Time (AGENT): 218569 ms
Total Talk Time (CUSTOMER): 157570 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/7db46674-69cf-466f-9f45-d9fdac093d2b_20250214T14:54_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yeah, I'm checking.
[CUSTOMER][NEUTRAL] Can they be us
[CUSTOMER][NEUTRAL] For the member.
[AGENT][NEUTRAL] I'm sorry, I can barely hear you.
[CUSTOMER][NEUTRAL] Uh, can you hear me?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yeah, can, can you hear me?
[AGENT][NEUTRAL] It's a little better, but it's still hard to hear you. How can I help you today?
[CUSTOMER][NEUTRAL] I'm checking status.
[AGENT][NEUTRAL] You're needing eligibility, is that correct? Yes, I can help you. And what is your name?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, my first name is [PII]. My last [PII] [PII]
[CUSTOMER][NEUTRAL] I'm calling from provider office.
[AGENT][NEUTRAL] Thank you, [PII]. And what is your callback number?
[CUSTOMER][NEUTRAL] Yeah, [PII], no extension.
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 2489437.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] Yeah, the first name is [PII]. First name is [PII]. The birth is [PII]. Sorry, sorry. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that she is the the subscriber on the supplemental policy and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And [PII], if a claim is going to be filed for this member with APL, we will also need for you to send a copy of her primary insurance company's explanation of benefits along with the claim for our review.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have processed our claim, we do have a portal that you can check claim status in and also have access to our explanation of benefits and the website for our portal is secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, thank you. Uh, can you
[CUSTOMER][NEUTRAL] Uh, once more until the.
[CUSTOMER][NEUTRAL] It'll give you status for the number.
[AGENT][NEUTRAL] Yes, the policy
[CUSTOMER][NEUTRAL] will get added.
[AGENT][NEUTRAL] The effective date is [PII] with no termination date.
[CUSTOMER][NEUTRAL] How
[CUSTOMER][NEUTRAL] No determination, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Uh, can you
[CUSTOMER][NEUTRAL] Uh, spell the epay ID.
[AGENT][NEUTRAL] I'm sorry, what was your question?
[CUSTOMER][NEUTRAL] Can you spell the plan name?
[AGENT][NEUTRAL] [PII] This is a supplemental policy.
[CUSTOMER][NEUTRAL] A medical policy, correct?
[AGENT][NEUTRAL] Supplemental policy.
[CUSTOMER][NEUTRAL] OK, then. Can you provide the
[CUSTOMER][NEUTRAL] Epay ready.
[AGENT][NEUTRAL] The payer ID, is that correct? 60801.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, thank you. Mailing address?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] What address do you have for this number?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] For the claims?
[CUSTOMER][NEUTRAL] Yeah, [PII] mailing address.
[AGENT][NEUTRAL] Yes, do you have that?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] What is it? What do you have?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, can you provide the client's mailing address?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK, thank you. Uh, can you provide the fax number?
[AGENT][NEUTRAL] [PII] attention claims.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, thank you. Uh, this is, this number is secondary insurance, correct?
[AGENT][NEUTRAL] I'm sorry, what was your question?
[CUSTOMER][NEUTRAL] This is [PII] Insurance, correct?
[AGENT][NEUTRAL] This is secondary. This is a supplemental policy to her primary insurance.
[CUSTOMER][NEUTRAL] OK. Thank you. Uh, can you check with the, can you check with the authorization is needed or not needed for the patient?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Did you ask if authorization is required?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] No, no, no prior authorization is required on this supplemental policy.
[CUSTOMER][POSITIVE] OK, thank you. Uh,
[CUSTOMER][NEUTRAL] Can you
[CUSTOMER][NEUTRAL] Can you provide a visit limit?
[AGENT][NEUTRAL] I'm sorry, what did you ask?
[CUSTOMER][NEUTRAL] Uh, can you provide the visit limit?
[AGENT][NEUTRAL] Uh, I'm not understanding you. I'm very sorry, [PII].
[CUSTOMER][NEUTRAL] [PII], um, can you provide a visit limit?
[AGENT][NEUTRAL] Did you, uh, I'm still not.
[CUSTOMER][NEUTRAL] Visit limit.
[AGENT][NEUTRAL] Sir,
[CUSTOMER][NEUTRAL] Can you provide a visit limit?
[AGENT][NEUTRAL] I'm very sorry, but I'm not understanding what you're asking me.
[CUSTOMER][NEUTRAL] Can you provide a digit limit?
[AGENT][NEUTRAL] Eligibility
[CUSTOMER][NEUTRAL] Visit a visit limit.
[AGENT][NEUTRAL] Are you asking if an office visit is covered?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm sorry, you didn't indicate that you needed benefit information. Just a moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] On this supplemental policy, office visits are not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. They, they not covered by another physical therapy and the office visit, correct?
[AGENT][NEUTRAL] Office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] OK, thank you. And may I know the spelling your name [PII]?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] I'm sorry, what was your question?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Can you spell your name [PII]?
[AGENT][NEUTRAL] [PII] first initial to last name [PII], and my name along with today's date will be your call reference number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] To the date, correct?
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][NEUTRAL] OK. Can you spell your name?
[CUSTOMER][NEUTRAL] [PII] for
[AGENT][NEUTRAL] Do you
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] You need for me to, do you need for me to spell it again?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] R A C I.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] [PII]. Correct.
[CUSTOMER][POSITIVE] Oh, OK. OK, thank you, uh, that's it. Have a nice day. Bye-bye.
[AGENT][POSITIVE] That is correct.
[AGENT][POSITIVE] You're welcome, [PII]. Yes, if that's all I can help you with, thank you again for calling APL and I hope you have a nice day also.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][POSITIVE] Uh-huh, you're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah