AccountId: 011433970860
ContactId: a1778f08-ed4f-420a-ba8c-0bcaea3fc5df
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221679 ms
Total Talk Time (AGENT): 88418 ms
Total Talk Time (CUSTOMER): 114207 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/a1778f08-ed4f-420a-ba8c-0bcaea3fc5df_20250428T15:28_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, hi, good morning, [PII]. My name is [PII], and I just need to verify um patients' physical therapy benefits, please, using this as a secondary plan.
[AGENT][POSITIVE] Good morning I could assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[CUSTOMER][NEUTRAL] Policy number is 02597280ML8.
[AGENT][NEUTRAL] Give me that policy number one more time.
[CUSTOMER][NEUTRAL] Sure, 02597280 and then the letters ML and then the number 8 is what I have here.
[AGENT][NEUTRAL] Thank you, [PII]. Could you verify the patient's name and date of birth that you're calling to verify benefits for?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Sure, it's [PII] and it's [PII].
[AGENT][NEUTRAL] Mm, I don't have that date of birth.
[AGENT][NEUTRAL] The name matches but not the date of birth.
[CUSTOMER][NEGATIVE] It doesn't surprise me. They keep, they keep entering the wrong information here on me here all the time. Uh, let me see, I might be able to get it.
[CUSTOMER][NEUTRAL] Um, oh yeah, [PII]. I entered it wrong again.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] [PII], this policy has been active since [PII] and it's currently active, and you're calling to verify benefits and eligibility for outpatient services.
[CUSTOMER][NEUTRAL] Yes, outpatient physical therapy.
[AGENT][NEUTRAL] She has outpatient benefits of $3000 per calendar day and this is not a guarantee of benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK, so it's 3000 per day per calendar day?
[AGENT][NEUTRAL] Yes, that is correct per calendar day Monday, Tuesday, Wednesday, Thursday, $3000 each day.
[CUSTOMER][POSITIVE] Oh wow, OK, that's nice. Uh, is there any authorization or anything like that or is it just?
[AGENT][NEUTRAL] Mhm. That's what I just said to myself.
[AGENT][NEUTRAL] No, this is a gap insurance. This is a gap insurance that assists with deductible, co-pay and co-insurance to the primary.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Now
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Got you. OK, perfect. Um, and I also have another patient too, uh, yeah, I have another patient I need, yeah, I need you to check too, that also has the same type of insurance. Uh, is there a call re are they gonna be separate call reference numbers or will it be the same?
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[AGENT][NEUTRAL] We don't have reference numbers.
[AGENT][NEUTRAL] It'll be my name and today's date for both patients.
[CUSTOMER][NEUTRAL] You don't? OK, yeah.
[CUSTOMER][NEUTRAL] OK perfect and then the second patient then.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] Would be um.
[CUSTOMER][NEUTRAL] 01820389 ML 8
[AGENT][NEUTRAL] And what is this member's name?
[CUSTOMER][NEUTRAL] Uh, [PII], and it's 7-17-1978.
[AGENT][NEUTRAL] This policy has been active since [PII] and it's currently active, calling to verify outpatient benefits. She has $500 per calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, same thing.
[CUSTOMER][POSITIVE] 500 per day in that one. OK, perfect.
[AGENT][NEUTRAL] Yes, and this is not a guarantee of benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] OK, and then uh what is your first and last name again? I'm sorry, I forgot.
[AGENT][NEUTRAL] My name is [PII], and I didn't provide my last name, but the first initial of my last name is [PII].
[CUSTOMER][POSITIVE] [PII] and then today's date. OK, thank you so much. I appreciate your help.
[AGENT][POSITIVE] You're welcome thanks for calling APL and have a great day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Bye.