AccountId: 011433970860
ContactId: a9c0f131-2688-4f04-9ce8-b28f9dbdff40
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 191440 ms
Total Talk Time (AGENT): 68568 ms
Total Talk Time (CUSTOMER): 60241 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/a9c0f131-2688-4f04-9ce8-b28f9dbdff40_20250521T18:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office to check eligibility and benefits for physical therapy. Could you please help me?
[AGENT][POSITIVE] Happy to check on eligibility and benefits, [PII]. What's the patient policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is
[CUSTOMER][NEUTRAL] 02573210
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. So, patient is active. Effective date is [PII]. We are the members secondary insurance, so this will cover deductible, co-pay, co-insurance. The primary does not.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, sorry, for the patient, uh there's no patient responsibility?
[AGENT][NEUTRAL] Were their secondary insurance.
[CUSTOMER][NEUTRAL] What's in turn.
[AGENT][NEUTRAL] You're just checking for eligibility and benefits, yes?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So we're the secondary insurance, this picks up their deductible co-pay co-insurance from the primary.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Their outpatient benefit max is $1000 for the calendar year and inpatient is $5000.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Actually, I show here it it is secondary plan, right? uh.
[CUSTOMER][NEUTRAL] The secondary, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And uh for this, may I know the plan type and the group number?
[AGENT][NEUTRAL] It's a meddling plan.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Group number is 19874.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there any deductible and copay?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. It will be covered by the primary insurance, right?
[AGENT][NEUTRAL] I don't know what the primary deductible copay or co-insurance is. You would need to check with them or the insured.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And is there any visit limit and for physical therapy?
[AGENT][NEUTRAL] No, there's not. The outpatient benefit max is $1000.
[CUSTOMER][NEUTRAL] OK, could you please spell out your name with your last name first initial and the call reference number?
[AGENT][NEUTRAL] [PII] last initial is [PII]. Call reference is my name with today's date.
[CUSTOMER][POSITIVE] OK, thanks for giving this information have a great day.
[AGENT][NEUTRAL] You too bye bye.