AccountId: 011433970860
ContactId: b8a0b3e4-6fe9-4513-bfab-4152e20b3092
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 216139 ms
Total Talk Time (AGENT): 85917 ms
Total Talk Time (CUSTOMER): 73029 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/b8a0b3e4-6fe9-4513-bfab-4152e20b3092_20250214T18:55_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good afternoon [PII]. I'm calling from Doctor [PII]'s office for the to see if for network and if it's.
[CUSTOMER][NEUTRAL] A patient is covered, or well, yeah, it's covered.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility and benefits. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] My name is YSL, um, [PII].
[AGENT][NEUTRAL] And the member's policy number?
[CUSTOMER][NEUTRAL] Members's policy number is.
[CUSTOMER][POSITIVE] No worries the policy number.
[CUSTOMER][NEUTRAL] Uh, plan, oh wait, hold on.
[CUSTOMER][NEUTRAL] Is it the one that says 2022?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so I have 02212824.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Leroy, and a number 8.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Patient's first name is [PII]. Last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So, um, this is the member's secondary insurance, so there's no um network in terms of in-network providers or out of out of network providers. We apply to the co-pay, deductible and co-insurance after primary insurance.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Does he have benefits for physical therapy? Does it cover that?
[AGENT][NEUTRAL] Let's see, hold on one moment.
[AGENT][NEUTRAL] So the policy will pay up to $2500 per calendar year for outpatient expenses, which does include physical therapy and a physical therapy facility. Did you want me to see if any of the 2500 has been used?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So he's used $197.41. There's a remaining $2,302.59 for [PII].
[CUSTOMER][NEUTRAL] OK perfect and you said only 1401 90 cents was used?
[AGENT][NEUTRAL] Um, hold on one moment. 19741.
[CUSTOMER][NEUTRAL] Uh 119.
[CUSTOMER][NEUTRAL] OK perfect thank you. Can I have a reference number for this call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] And your first name? I'm sorry?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] And then you would, you said it would be your name and today's date?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, so [PII] [PII].
[CUSTOMER][POSITIVE] OK perfect thank you.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you bye bye.