AccountId: 011433970860
ContactId: bd788db5-d434-4a98-b290-7d2860491937
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 246529 ms
Total Talk Time (AGENT): 117280 ms
Total Talk Time (CUSTOMER): 59136 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/bd788db5-d434-4a98-b290-7d2860491937_20250317T13:24_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from AT Physical Therapy looking benefits and eligibility.
[AGENT][POSITIVE] OK, sure. I can assist you with the eligibility and benefits, Ms. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah, callback number [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Um, sure. Our policy number is
[CUSTOMER][NEUTRAL] 01702710
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I just like
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, my first name is [PII] Last name [PII].
[CUSTOMER][NEUTRAL] His date of birth, number [PII].
[AGENT][NEUTRAL] Thank you. And you say you need eligibility and benefits for physical therapy, correct?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] All right. Thank you.
[AGENT][NEUTRAL] Let me pull the benefits.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. Um, this is one of our secondary supplemental plan to the major medical and we have an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I'm still waiting on the benefits to pull up. OK, one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] All right, so for this one, we do cover physical therapy. This is subject to the outpatient maximum, which is 4000 per cover person per calendar year.
[CUSTOMER][NEUTRAL] So for any accumulation on that?
[AGENT][NEUTRAL] Um I can check and see.
[AGENT][NEUTRAL] As of today, um, she has not used her benefits, so she still have the full amount available.
[CUSTOMER][NEUTRAL] Thank you, ma'am. This patient does not have any deductible or co-insurance, right?
[AGENT][NEUTRAL] Not with us, we are just the secondary.
[CUSTOMER][NEUTRAL] OK, ma'am. Can I get the claim mailing address?
[AGENT][NEUTRAL] Sure, that's [PII].
[AGENT][NEUTRAL] [PII] City, [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 50. And payer ID please?
[AGENT][NEUTRAL] OK, this one needs to be sent by mail or fax because it's a secondary and we need the copy of the explanation of benefits attached to it, but for your records, the payer ID is 60801.
[CUSTOMER][POSITIVE] 6080. Thank you so much, ma'am. uh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Could you please spell your name and your reference number for this call?
[AGENT][NEUTRAL] My name is [PII], and we don't have reference numbers, so you can use my name in today's date.
[CUSTOMER][POSITIVE] Thank you, sir. Have a wonderful rest of the day. Bye-bye.
[AGENT][POSITIVE] You're welcome. You as well. Thank you for calling APM. Bye bye.