AccountId: 011433970860
ContactId: 9ebc7202-ecf0-4b80-988d-c97764072c7e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 189770 ms
Total Talk Time (AGENT): 70730 ms
Total Talk Time (CUSTOMER): 58774 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/9ebc7202-ecf0-4b80-988d-c97764072c7e_20250312T21:17_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Cora Physical Therapy. I was just calling to get the eligibility and benefits for a patient that we see in our office.
[AGENT][POSITIVE] Sure, I'll be more than happy to help you with the eligibility and the benefits. And you said your name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And there may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it is [PII] and I have an extension that is also [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, it is 1452971 M as in Mary, L as in Lima, and then the number 8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes. It is.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And then her date of birth is, sorry, give me just a second.
[CUSTOMER][POSITIVE] OK good.
[CUSTOMER][NEUTRAL] There we go. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active, it's been effective since [PII]. And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Outpatient physical therapy.
[AGENT][NEUTRAL] OK, so the outpatient benefit is up to $5000 per calendar year.
[AGENT][NEUTRAL] That does include physical therapy and a physical therapy facility.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you want me to see if any of the 5000 has been used? Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Does she have?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Sure, OK, hold on one moment.
[AGENT][NEUTRAL] So, so far for [PII], she has not used any of the benefits, so she still has that full 5000 for the calendar year.
[CUSTOMER][NEUTRAL] OK, and um so there's no copay or co-insurance or anything with you guys?
[AGENT][NEUTRAL] No, so we help pay that if primary applies it. Um, we pay towards the copay, deductible and co-insurance after primary of our cover charges.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Was there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] No, ma'am, that was all.
[AGENT][POSITIVE] Alrighty well thank you so much for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.