AccountId: 011433970860
ContactId: bde65203-e2bb-4570-9902-47df11477150
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 237940 ms
Total Talk Time (AGENT): 121664 ms
Total Talk Time (CUSTOMER): 82312 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/bde65203-e2bb-4570-9902-47df11477150_20250317T19:58_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, this is So with APL. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling to see if um with this insurance as a secondary insurance, if there's any out of network benefits available.
[AGENT][NEUTRAL] OK, I can check. And may I have your name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And Ms. [PII], this is your policy or you're calling from provider's office?
[CUSTOMER][NEUTRAL] I'm calling from a provider's office.
[AGENT][NEUTRAL] OK. May I have a callback number just in case we get disconnected and the name of the facility for my notation.
[CUSTOMER][NEUTRAL] Yes, of course. The callback number is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And the name of the facility is Children in Motion.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] 022
[CUSTOMER][NEUTRAL] 123 83 ML 8.
[AGENT][NEUTRAL] OK. What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, the name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. All right, Miss, this particular policy is a secondary supplemental plan to the major medical. We follow primary.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK perfect so there would not be out of network benefits then?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We follow them if, if they have out of network than we do. If they don't, then we don't. Um, we just follow completely what they say.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So it's up to the primary.
[CUSTOMER][NEUTRAL] OK perfect so the primary does have out of network benefits.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. And what type of service is, OK, what type of service is being rendered so I can tell you if it's covered under the secondary.
[CUSTOMER][NEUTRAL] Is what I was told.
[CUSTOMER][NEUTRAL] The occupational and speech therapy.
[AGENT][NEUTRAL] Occupational speech. OK, um.
[CUSTOMER][NEUTRAL] Or actually, sorry, just speech therapy, just speech therapy, sorry.
[AGENT][NEUTRAL] Just each. OK, let me check with this one to see if it's covered, OK? Because we do not cover just everything, OK? You're welcome. One moment. You're welcome.
[CUSTOMER][NEUTRAL] He
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] All right. 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. And OK, so this one covers physical therapy, um, let me see what other therapies. OK, so this one does not cover speech or occupational, only covers physical therapy only.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, perfect. So there would be no benefits then. OK, perfect. Thank you so much for letting me know. I appreciate it.
[AGENT][NEGATIVE] No coverage on this one.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today, Miss [PII]?
[CUSTOMER][NEUTRAL] Um, no, if I could just have um a reference number, please.
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, sure. That's S [PII]. Last initial is [PII].
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day, Ms. [PII]
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you.