AccountId: 011433970860
ContactId: 9dcd3328-78bb-4d83-b378-ddcf7cabfabf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201339 ms
Total Talk Time (AGENT): 92788 ms
Total Talk Time (CUSTOMER): 83238 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/9dcd3328-78bb-4d83-b378-ddcf7cabfabf_20250623T19:50_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling to go ahead and um.
[CUSTOMER][NEUTRAL] Get benefits for mutual patients to see if it covers.
[CUSTOMER][NEUTRAL] Office visits, X-rays, DMEs, and a physical therapy.
[AGENT][POSITIVE] I'm sure, [PII] I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] It'll be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Um, I have here.
[CUSTOMER][NEUTRAL] I have 0202.
[CUSTOMER][NEUTRAL] 1778 ML 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] The patient's name is [PII] and then date of birth is [PII].
[AGENT][NEUTRAL] OK, thanks and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active.
[AGENT][NEUTRAL] And let's see. You said this is for physical therapy and DME and what else?
[CUSTOMER][NEUTRAL] Um, just to see if it covers the offices, X-rays and ultrasounds, uh, DME and uh physical therapy.
[AGENT][NEUTRAL] OK, yes, all of those are covered under the outpatient benefit and for outpatient services, we cover up to 7350 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so it covers everything covers.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] OK. The only thing it does not cover um is for um regular office visits, um, not physical therapy, but, um, regular office visits, um, we don't cover the copay for the office visits, but we do cover treatment um for the office.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Visits.
[CUSTOMER][NEUTRAL] OK, so like the X-rays and that's covered for sure and then um because that's like would be like a treatment and then any DMEs as well and then physical therapy, if it has a copay, then it doesn't, it's not covered or it is covered.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] It is covered.
[CUSTOMER][POSITIVE] Covered OK perfect.
[CUSTOMER][POSITIVE] Alrighty perfect thank you so much. Can I have a reference number for this call?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII] um it's spelled [PII] Last initial is [PII] and today's date. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] And the verify
[CUSTOMER][POSITIVE] No, that would be all thank you so much.
[AGENT][POSITIVE] OK, thank you, [PII], for calling ATL. Have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Mm, thank you.