AccountId: 011433970860
ContactId: 8dc3e973-3ecb-476b-8064-07f0d47fd908
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 220350 ms
Total Talk Time (AGENT): 123452 ms
Total Talk Time (CUSTOMER): 45574 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/8dc3e973-3ecb-476b-8064-07f0d47fd908_20250213T13:48_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. I'm calling to get um information about a patient's benefits and to see if pre-authorization is required for outpatient physical therapy in a hospital setting.
[AGENT][NEUTRAL] Patient physical therapy in a hospital setting. All right. Well, I'll be more than happy to help you with the benefits. Um, there's no prior authorization or pre-certification required for any APL policy because we're not the major medical, but I can definitely take a look at the benefits for you and let you know what the coverage is.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII] and that's [PII] Contact number is [PII].
[AGENT][NEUTRAL] Thank you for that and may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is 202588322.
[AGENT][NEUTRAL] Thank you and can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth is going to be [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And for outpatient benefits,
[AGENT][NEUTRAL] Well, hold on one moment.
[AGENT][NEUTRAL] This one is broken down a little different. Do you mind if I place you on just a brief hold so I can pull up the full document? Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Wow, this looks totally different.
[AGENT][NEUTRAL] Let's do this.
[AGENT][NEUTRAL] And I don't think there's any PT.
[AGENT][NEUTRAL] I don't see that on there.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Physical speech, occupational.
[AGENT][NEUTRAL] 30 per day max, OK.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. So, for this policy, so it is a hospital indemnity policy, but there is physical therapy benefits. The policy will pay up to $30 per day, with a max of 4 days per calendar year for physical, speech or occupational therapy, um.
[AGENT][NEUTRAL] At
[AGENT][NEUTRAL] Whichever facilities, uh, whichever type of therapy facility.
[CUSTOMER][NEUTRAL] You said you'll pay $30 per day for how many days? I'm sorry.
[AGENT][NEUTRAL] 4 days per calendar year.
[CUSTOMER][NEUTRAL] 4
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK OK
[AGENT][NEUTRAL] All right. And was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Yes, can I get a reference number for our call today?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date, and that's [PII] The [PII] my [PII] is [PII] and today's date.
[CUSTOMER][NEUTRAL] OK, and did you say um his plan was a secondary?
[AGENT][NEUTRAL] It's a hospital indemnity policy. If he does have another type of policy, it could be second, but this is just a limited benefit policy.
[CUSTOMER][POSITIVE] OK, I got it I appreciate it thank you.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL and [PII]. I hope you have a great day.
[CUSTOMER][POSITIVE] Alright, sounds good thank you.
[AGENT][POSITIVE] You're welcome bye bye.