AccountId: 011433970860
ContactId: b14e539b-b900-439d-ada4-c2b5d06ceea8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 278660 ms
Total Talk Time (AGENT): 99793 ms
Total Talk Time (CUSTOMER): 124634 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/b14e539b-b900-439d-ada4-c2b5d06ceea8_20250602T18:31_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Hi, this is [PII]. I'm calling you because I would like to get benefits for a member. Can you help me with that, please?
[AGENT][POSITIVE] Um, yes, ma'am. I can assist you with benefits. Um, first, I'll need your name again and a good callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] Of course, yes. My name is [PII]. This is spelled [PII]. That my phone number is [PII]. Let's see the next number.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. It's now could I get the policy number, please?
[CUSTOMER][NEUTRAL] Yes, the policy number for this member, it's, let's see one moment here.
[CUSTOMER][NEUTRAL] Policy number, it's
[CUSTOMER][NEUTRAL] 016891.
[CUSTOMER][NEUTRAL] 57
[CUSTOMER][NEUTRAL] M L
[AGENT][NEUTRAL] OK. And please, thank you. Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] This is for [PII]. Date of birth for this member is [PII].
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active, and is this for inpatient or outpatient benefits or an office visit?
[CUSTOMER][NEUTRAL] This is for office visit?
[AGENT][NEUTRAL] OK, for services provided in office, we cover up to $500 per day and that's for the um co-insurance and the deductible after the primary insurance processes the claim, but the co-pay for the office visit is not covered.
[CUSTOMER][NEUTRAL] So I is my father on the member's plan.
[AGENT][NEUTRAL] That's correct. Office visits are, is not covered, but office treatments are covered up to 500 per day.
[CUSTOMER][NEUTRAL] All right, I understand. So, but uh for the general physical therapy because we, this is for physical therapy office visit. So for the general physical therapy office visit, it's not covered, right?
[AGENT][NEUTRAL] Oh, well, for physical therapy, um,
[AGENT][NEUTRAL] And that is covered. The copay coinsurance and deductible is covered for physical therapy, 500 per day.
[CUSTOMER][NEUTRAL] 500 per day.
[AGENT][NEUTRAL] Yes, ma'am. After the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] Alright, so, but that one is the deductible of $500 per day.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Alright, I got it. Thank you very much for let me see, $500.
[CUSTOMER][NEUTRAL] $500 per day.
[CUSTOMER][NEUTRAL] Uh, after deductible copying for insurance, after, um.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] The first after deductible.
[CUSTOMER][NEUTRAL] Co-pay and car insurance.
[CUSTOMER][NEUTRAL] And first.
[CUSTOMER][NEUTRAL] Coverage, a first policy coverage.
[AGENT][NEUTRAL] Right. Once the um primary insurance process. mhm, go ahead.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Once the mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Once the primary insurance process.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] All right. Thank you very much for that. I'm sorry, could you please repeat your name?
[AGENT][NEUTRAL] Um yes, my name is [PII]. It's spelled [PII] and my last initial is [PII], and my name and today's date will be your reference number. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] I'm sorry, what, what would be the my reference number, your name?
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][POSITIVE] And then to your last name, I'm sorry.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] Thank you very much for that, [PII]. So have a wonderful day. Take care. Bye-bye.
[AGENT][NEUTRAL] You do the same. It's a thank you for calling APL. Mm bye.
[CUSTOMER][NEUTRAL] I