AccountId: 011433970860
ContactId: b2dd9849-6a6c-46b5-9b41-3c257df943ad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 260980 ms
Total Talk Time (AGENT): 112108 ms
Total Talk Time (CUSTOMER): 47103 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=-1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/b2dd9849-6a6c-46b5-9b41-3c257df943ad_20250605T13:45_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Need much like whether a patient has active coverage still or not.
[AGENT][POSITIVE] OK, I can definitely help you with the eligibility. May I have your name and a good contact number?
[CUSTOMER][NEUTRAL] Name is [PII], initial is [PII].
[CUSTOMER][NEUTRAL] Number is [PII], no extension.
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] I have that as 01648523.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And did you need to go over any
[CUSTOMER][NEUTRAL] OK, can you tell me what?
[CUSTOMER][NEUTRAL] Yes, I'm looking for outpatient physical therapy.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold while I pull up the benefits?
[CUSTOMER][NEGATIVE] Not at all. Take as long as you need.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] We say what now? It looks like it only covers outpatient hospital.
[AGENT][NEUTRAL] Not really sure. I've never seen this before.
[AGENT][NEUTRAL] But that's what it looks like it'll pay 500 wait let me just pull it up.
[AGENT][NEUTRAL] $2400 per calendar year, $500 deductible, waived if it's an accident.
[AGENT][NEUTRAL] I don't see any more mental or emotional.
[AGENT][NEUTRAL] Let's see if this.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh.
[AGENT][NEGATIVE] Doesn't have any physical therapy coverage.
[AGENT][NEUTRAL] I just want to make sure that that didn't include.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. Um, so the policy does not have any coverage for physical therapy. Um, under outpatient, it covers like the emergency rooms, outpatient surgery, um, diagnostic testing, and then it covers like mental or emotional, um,
[AGENT][NEUTRAL] Disorders in the hospital outpatient facility but no like physical therapy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, that works for me then. Can I get a call reference number from you please?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date, and the first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] You said your name was [PII]?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Alright, thank you very much I appreciate it.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No ma'am, that's it.
[AGENT][POSITIVE] Alright, thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thank you