AccountId: 011433970860
ContactId: a5f637cb-1a56-4daf-850f-1998e6f25590
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 161029 ms
Total Talk Time (AGENT): 63752 ms
Total Talk Time (CUSTOMER): 69806 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/a5f637cb-1a56-4daf-850f-1998e6f25590_20250110T15:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from provider's office to check on the business benefits.
[AGENT][NEUTRAL] May I have a callback number?
[CUSTOMER][NEUTRAL] Yes, it's gonna be [PII] with no extension.
[AGENT][NEUTRAL] May I have the policy number?
[CUSTOMER][NEUTRAL] Oh yes.
[CUSTOMER][NEUTRAL] Um, it's gonna be 01523996. M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm. It's gonna be um uh [PII] of [PII].
[AGENT][NEUTRAL] And you're calling in for benefits, is there a specific benefit that you're calling in for?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I'm looking for some specific benefits.
[AGENT][NEUTRAL] For an office visit, outpatient?
[CUSTOMER][NEUTRAL] No, no. Uh yeah, it's for the outpatient hospital facility and it's gonna be the occupational therapy, occupational therapy.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You want with the CPT code?
[AGENT][NEUTRAL] No, no CP CPT code is needed.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And you're calling in for occupational therapy benefits verification of coverage does not guarantee the payment of the claim. For this policy, it is showing that occupational therapy is not covered.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Occupational therapy is not covered, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, may I know which of the service is covered for this patient?
[AGENT][NEUTRAL] For occupational therapy, it is a non-covered benefit, it's an exclusion.
[CUSTOMER][NEUTRAL] I is, is the policy covered for the physical therapy or speech therapy?
[AGENT][NEUTRAL] Speech therapy is not covered either, but it looks like physical therapy is considered a covered benefit.
[CUSTOMER][NEUTRAL] Mhm. Occupational therapy is not covered. Thank you so much for that. Um, can I have the effective date and the call reference number?
[AGENT][NEUTRAL] The effective date is [PII] and currently active. The call reference will be my first name [PII], last initial of [PII] and today's date. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No, thanks. That's it, [PII] and have a nice day. Thank you for your assistance.
[AGENT][POSITIVE] Same to you. Thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] You too.