AccountId: 011433970860
ContactId: a19ca2a8-c545-4e38-bc21-83c34d630de6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 345700 ms
Total Talk Time (AGENT): 150910 ms
Total Talk Time (CUSTOMER): 108121 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=2.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/a19ca2a8-c545-4e38-bc21-83c34d630de6_20250203T20:30_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL this is [PII] how may I help you?
[CUSTOMER][NEUTRAL] Yes, hi. I was trying to get in touch with American Public Life. Is this the same number?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. Yes, I'm, I'm trying to verify uh medical uh benefits for a patient of mine.
[AGENT][POSITIVE] OK, I can help you with benefits. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] My first name is [PII] and my callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. What is the patient's name?
[CUSTOMER][NEUTRAL] Patient's first name [PII]. Last name [PII].
[AGENT][NEUTRAL] OK, and what's Ms. [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then also what is [PII]'s policy number?
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] OK, that's our payer ID number to send claims electronically.
[CUSTOMER][NEUTRAL] Oh, yes, OK, that's the number that she gave me. She also gave me a different number. Um, is it 262-6087?
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] That sounds like a good number. Let me look that one up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 262-6087. Is that correct?
[CUSTOMER][POSITIVE] That is correct, yes.
[AGENT][NEUTRAL] OK, that's not pulling in her policy. Let me see if I can find it by her name.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Can you spell her last name [PII]?
[CUSTOMER][POSITIVE] That is correct, yes.
[AGENT][NEUTRAL] And then [PII]?
[CUSTOMER][NEUTRAL] No, I have it as uh [PII] Let me see the uh, yeah, [PII]. Mhm.
[AGENT][NEUTRAL] OK. Ah, OK.
[AGENT][NEUTRAL] All right, let me see if she has an active policy with us.
[CUSTOMER][NEUTRAL] said that the policy is under [PII] and that's the uh husband. Mhm.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yes, I do find the policy, um, and it does match her date of birth. I believe I have her up now. She does have an active policy. Her effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this is just to verify her coverage. It's not a guarantee of payment. She has a supplemental insurance policy that's billed secondary to the primary.
[AGENT][POSITIVE] It helps with deductible, co-pay, and co-insurance.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And she has an inpatient benefit amount of $6600 and then she also has, and that's per calendar year, she also has an outpatient benefit amount per calendar day of $400.
[CUSTOMER][NEUTRAL] OK. So it does cover daily $400 that's what you're telling me?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me put here [PII].
[AGENT][NEUTRAL] Now, is she gonna be going inpatient?
[CUSTOMER][NEUTRAL] No, no. Everything is outpatient. It's for physical therapy that she's, uh, she's having therapy tomorrow, studying, uh, and she wanted to know if this will cover physical therapy as well.
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Let me pull in the policy and see.
[AGENT][NEUTRAL] If she has physical therapy benefits on it, it's gonna be just a second while I pull that up and I read the policy.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right. I've got the policy up. I just need to scroll through it and read it real quick to see what it says about physical therapy.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, she does have um the treatment of uh physical therapy in an office center or clinic in which a licensed physical therapist provides physical therapy.
[CUSTOMER][NEUTRAL] OK, perfect. That's what I wanted to know. And can you kindly provide me with that policy number that she has?
[AGENT][NEUTRAL] Yes ma'am, I sure can. The policy number is 2415265.
[CUSTOMER][POSITIVE] Perfect. Thank you. And can I have a reference number on my call?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, you can use my name. It's [PII] and today's date.
[CUSTOMER][POSITIVE] Sorry, thank you so much. I appreciate all your effort and looking into this and answering all my questions. You have a wonderful day.
[AGENT][POSITIVE] You too [PII] you have a blessed one thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You too. You're welcome bye bye.
[AGENT][NEUTRAL] Bye-bye.