AccountId: 011433970860
ContactId: 7f64ae2c-d159-4427-bcaa-443032748bb5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 158259 ms
Total Talk Time (AGENT): 110280 ms
Total Talk Time (CUSTOMER): 34468 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/7f64ae2c-d159-4427-bcaa-443032748bb5_20250203T18:44_UTC.wav
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[AGENT][NEUTRAL] contacting APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm trying to get benefits for a patient secondary insurance.
[AGENT][NEUTRAL] I can help with benefits. With whom am I speaking, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Yes, and thank you. What's that policy number we're looking at today?
[CUSTOMER][NEUTRAL] 02175352ML8
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and is there a callback number I could have please in the event that we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII]. It is active. Now, the secondary insurance, um, we are meant to pick up the deductible, co-payment, or co-insurance for in and out of hospital settings for Ms. [PII] for outpatient services such as the ER, urgent care, treatment with the physician's office, cancer treatment, durable medical, that sort of thing, independent lab. And what we will do is we will pick up the deductible, co-payment or co-insurance.
[AGENT][NEUTRAL] From her major medical.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Oh my goodness, what is happening here.
[AGENT][NEUTRAL] There we go.
[AGENT][NEUTRAL] Uh, we will pick up that deductible, co-payment or co-insurance from her major medical.
[AGENT][NEUTRAL] Up to $6000 per calendar year. Now that's just a verification of the benefits, not a guarantee of payment. Um, is there anything in particular that I could tell you? Would you like the inpatient benefits as well?
[CUSTOMER][NEUTRAL] Physical therapy, does it cover that?
[AGENT][NEUTRAL] Uh, it does cover physical therapy. That's going to come under that $6000.
[AGENT][NEUTRAL] I don't, I'm just checking to see whether she's used any for this calendar year. It doesn't look like she has. So it looks like the entire $6000 will be available. Uh, again, just a verification, not a guarantee of payment. And what you're going to do, [PII], if you're gonna file through their major medical first and then through us. Yes, uh, physical therapy, uh, um, speech therapy, uh, occupational therapy, those are not covered, but physical therapy is.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Under that outpatient benefit. Is there anything else at all that I may help with?
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] No, that's it. Is there any form of reference number?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is K as in kite, and we're gonna use that today's date as our reference.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK, well, do you have any other questions, please let us know. Thanks for contacting ATL.
[CUSTOMER][POSITIVE] Perfect thank you so much.
[CUSTOMER][NEUTRAL] No, that is it.
[AGENT][POSITIVE] You have a good