AccountId: 011433970860
ContactId: a8eb5066-674b-4f8d-a3e3-7e375a7cf067
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163240 ms
Total Talk Time (AGENT): 82278 ms
Total Talk Time (CUSTOMER): 75657 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/a8eb5066-674b-4f8d-a3e3-7e375a7cf067_20250425T15:23_UTC.wav
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[AGENT][NEUTRAL] Contacting APO, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from provider's office to check on a patient's benefits, ma'am.
[AGENT][NEUTRAL] I can help with benefits, [PII]. What is that policy number, please?
[CUSTOMER][NEUTRAL] 02212383. M as in Mary, L as in Lima, number 7.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII] of [PII].
[AGENT][NEUTRAL] Thank you. I just need a callback number, please, in the event that we're disconnected.
[CUSTOMER][NEUTRAL] Oh yes, it's gonna be [PII] with no extension.
[AGENT][POSITIVE] OK, thank you so much. So it looks like
[AGENT][NEUTRAL] The policy went into effect on [PII]. It is active. Now you mentioned benefits, uh, this secondary, yes, uh-huh.
[CUSTOMER][NEUTRAL] Yes, ma'am. Um, uh, may I know whether this patient covers the speech therapy, speech therapy evaluation you want with the CPT code? It's 92523.
[AGENT][NEUTRAL] Uh, no. Uh, the only thing that it covers is physical therapy. Now, speech, um, occupational therapy, uh, kinesiology, none of those things are covered. Uh, the only thing that would be covered would be physical.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] OK, can you please repeat one more time? You said that there is uh this patient uh covers a policy of physical therapy and the evaluation, not the speech therapy, is that right?
[AGENT][NEUTRAL] It is, it, it only covers physical therapy. That, that's it.
[CUSTOMER][NEUTRAL] OK. There is no, there is no occupational therapy and speech therapy as well, right?
[AGENT][NEUTRAL] That is correct. Yeah, it is not covered. That is not covered.
[CUSTOMER][NEUTRAL] OK, ma'am. Uh, what about the physical therapy? How much was covered for this for this number?
[AGENT][NEUTRAL] Now, for physical therapy, the um policy will pick up the deductible, co-payment or co-insurance up to $500 per calendar day. That's just a verification of the benefits, not a guarantee of payment, but that is what it would do for physical therapy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] How much was met in the $500?
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Well, it's $500 per day, [PII], so it, it renews each and every day. So it, it's, it's not, there's not a calendar year balance. It's every single day.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Got it, got it. Thank you. Uh, you said, I'm repeating that one more time for benefits, ma'am. It's gonna, you said it covers only the physical therapy and speech therapy is not covered under this plan for this patient, right?
[AGENT][POSITIVE] That is right. Uh-huh.
[CUSTOMER][POSITIVE] Thank you, ma'am. Thank you so much. Can I get the reference number?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We're gonna use that today's date as a reference. Is there anything else at all that I can help with?
[CUSTOMER][NEUTRAL] [PII], OK.
[CUSTOMER][POSITIVE] No, [PII]. Have a nice day. Thank you so much for your assistance. Have a nice day. Bye.
[AGENT][POSITIVE] OK, thanks for contacting ATL have a very good day.