AccountId: 011433970860
ContactId: b9234d7e-e830-4a71-a9bb-53e3df8e394d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 428570 ms
Total Talk Time (AGENT): 172164 ms
Total Talk Time (CUSTOMER): 88134 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/b9234d7e-e830-4a71-a9bb-53e3df8e394d_20250114T19:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Hi I was calling for eligibility and benefits for a patient for physical therapy.
[AGENT][POSITIVE] OK, I can help you with eligibility and benefits. Can I get your name, please?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] OK, thank you and then Ms. [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. I appreciate that. And what is the patient's name?
[CUSTOMER][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] What's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And his policy number?
[CUSTOMER][NEUTRAL] It's D437241-3.
[AGENT][NEUTRAL] OK and what kind of policy is?
[CUSTOMER][NEUTRAL] Oh, I'm sorry, did you say what kind of policy is it? Thank you.
[AGENT][NEUTRAL] Yes. Does it say the type of policy it is?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] I'm looking at his insurance card. do you know where it might say that?
[AGENT][NEUTRAL] It might say um like a hospital indemnity or um.
[CUSTOMER][NEUTRAL] Mm, I see.
[AGENT][NEUTRAL] Let me, um, that's not one of our policy numbers. Does he have a social security number and let me try to pull the policy in that way.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't have his social security number.
[AGENT][NEUTRAL] OK, alright, let me try to pull him up by his name.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] I don't owe you any money.
[CUSTOMER][NEUTRAL] You're all set. We have a card on.
[AGENT][NEUTRAL] OK, and you're just needing benefit information, is that correct?
[CUSTOMER][NEUTRAL] Yes, please, for physical therapy.
[AGENT][NEUTRAL] OK, so what I'm gonna need to do is I'm gonna need to transfer you on over to IMA let me give you that phone number in case the call is dropped.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you would choose option one.
[CUSTOMER][NEUTRAL] So I actually just came from there and they transferred me to here.
[AGENT][NEUTRAL] OK. All right. Um.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] It must, no, that's OK. I understand. He must have a different policy with us then. Um, let me look and see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because usually when we get a policy with that D number it's usually IMA 360.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So let me look. And you said his birthday was [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I've I think I've got it pulled up.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, he has several different policies with us. um, what kind of office are you?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] We're a physical therapy outpatient office.
[AGENT][NEUTRAL] OK, let me look. That would be his hospital indemnity, I believe.
[AGENT][NEUTRAL] OK, so, um, eligibility and benefits for therapy. His, um, effective date is [PII]. The policy is active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me
[AGENT][NEUTRAL] We pull in his policy and read it about physical therapy and see what's covered, if anything. I'm just gonna look at straight to the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just
[AGENT][NEUTRAL] And help you that way.
[CUSTOMER][POSITIVE] Thank you I really appreciate it.
[AGENT][POSITIVE] Oh it's not a problem at all.
[AGENT][POSITIVE] I don't mind helping. I like it. I like helping people.
[AGENT][NEUTRAL] OK, schedule benefits.
[AGENT][NEUTRAL] It's gonna take me just a second because it's a pretty large policy and I need to make sure I find what you need.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, no worries, take your time.
[AGENT][NEUTRAL] OK, looking at this policy, let me double check on this.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, the insured does not have outpatient benefits.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEUTRAL] He, I'm not, it's hospital confinement. It's accident and sickness surgery benefit, and diagnostic testing is on this policy, but I do not see outpatient benefits for the insured.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you and then can I just have your name and a reference number?
[AGENT][NEUTRAL] Yes, my name is [PII]
[AGENT][NEUTRAL] And you can use my name and today's date is your reference number.
[CUSTOMER][POSITIVE] OK perfect I really appreciate it thank you so much.
[AGENT][POSITIVE] It is no problem at all. I hope you have a blessed day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you you too mhm bye.
[AGENT][NEUTRAL] Bye-bye, Ms [PII].