AccountId: 011433970860
ContactId: 991097dd-496f-4ef3-aa09-441163f7b494
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194690 ms
Total Talk Time (AGENT): 77428 ms
Total Talk Time (CUSTOMER): 87794 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/991097dd-496f-4ef3-aa09-441163f7b494_20250514T17:47_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi, good afternoon. um I was calling to verify some benefit information for a patient.
[AGENT][NEUTRAL] OK, may I ask who's calling?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And do you have a phone number I can give?
[CUSTOMER][NEUTRAL] And I'm calling from yeah sure it's [PII].
[AGENT][NEUTRAL] Do you have the policy number?
[CUSTOMER][NEUTRAL] Sure it is policy.
[CUSTOMER][NEUTRAL] 02417219 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Were you needing claim status or benefits?
[CUSTOMER][NEUTRAL] Benefits.
[AGENT][NEUTRAL] OK, I can help you with that. Is it for outpatient, inpatient, or doctor's office?
[CUSTOMER][NEUTRAL] Mm, well, we're outpatient uh physical therapy, but we do bill under um.
[CUSTOMER][NEUTRAL] Place of service is 11 so would be office so I'm not sure how the the benefits are different between outpatient and and um and an office.
[AGENT][NEUTRAL] Yes ma'am, we pay it under outpatient. I can, I can give you those benefits. Um, the effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any benefits given over the phone is not a guarantee of payment. This policy coordinates with the primary insurance.
[CUSTOMER][NEUTRAL] It's only
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Whatever the primary applies to their deductible copay or co-insurance will pay up to
[AGENT][NEUTRAL] $500 per calendar day.
[CUSTOMER][NEUTRAL] OK, so that was basically what the mom's concern was if you guys would cover the copayment, so.
[AGENT][NEUTRAL] Yes, ma'am. We'll pay up to 500 per day.
[CUSTOMER][NEUTRAL] OK, uh, the next, so that's for the outpatient benefits, what are the office benefits just in case?
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[AGENT][NEUTRAL] Office visits or anything done in a doctor's office is not covered unless it is a cancer diagnosis.
[CUSTOMER][NEUTRAL] I'll send it.
[CUSTOMER][NEUTRAL] OK, so we're not a doctor's office. I'm not worried about that um OK uh very good and let me just confirm, can I have a claims address please? Mhm.
[AGENT][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Go
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Perfect thank you very much for your help I really appreciate it you have a good day.
[AGENT][POSITIVE] Thank you, [PII], for calling APLU as well.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.