AccountId: 011433970860
ContactId: be121050-a2f2-43f7-a555-bd2de7f62d08
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 456630 ms
Total Talk Time (AGENT): 145948 ms
Total Talk Time (CUSTOMER): 140350 ms
Interruptions: 5
Overall Sentiment: AGENT=0.7, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/be121050-a2f2-43f7-a555-bd2de7f62d08_20250213T17:13_UTC.wav
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[AGENT][POSITIVE] Thank you for calling PL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. Um, I'm calling because I have a gap insurance with you guys through my employer, and I'm starting to rack up some charges from, um, specialists, and I'm gonna be doing physical therapy and I've never filed a claim. I have no idea how to go about this process, so I was trying to get some insight, um, in some direction.
[AGENT][NEUTRAL] Hi
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, of course, and may I please ask you for your policy number?
[CUSTOMER][POSITIVE] Yes, let me get that for you.
[CUSTOMER][NEUTRAL] OK, it is 02326720.
[AGENT][NEUTRAL] Let me repeat that to you please. 023267-20?
[CUSTOMER][NEUTRAL] 023-267-20 yes.
[AGENT][POSITIVE] OK thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] May I have your name and date of birth? Thank you.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you, [PII], and if you would please give me your call back number if we are disconnected through the call.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and verify your complete mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you and the last thing to verify is your email address?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Is what?
[AGENT][NEUTRAL] Your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much for the verification process. OK, so let me pull up your policy.
[CUSTOMER][NEUTRAL] You sound like me this morning. Do you have allergies or you have the syphil allergies?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm just stuffy, yeah.
[CUSTOMER][NEGATIVE] I hope you're not coming down with something.
[AGENT][NEUTRAL] Just that is the weather, you know.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I hope not either. Oh my gosh, OK, I'm so sorry. Let me focused, OK.
[CUSTOMER][POSITIVE] Oh well best of luck there.
[AGENT][NEUTRAL] OK, now you mentioned specialist office visits I believe at the beginning of the call.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah, that and um.
[AGENT][NEUTRAL] And your policy.
[AGENT][NEUTRAL] Physical therapy. OK.
[AGENT][NEUTRAL] I will go ahead and tell you that your policy does not cover for a an office visit that could be with a PCP or specialist, so that's something that is not covered and your physical therapy give me one moment please.
[AGENT][NEUTRAL] May I place you on a brief hold please?
[AGENT][NEUTRAL] I'm so sorry, please.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] Uh, let's see.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for your patience with me. In regards to your physical therapy, um, please note verification of benefits provided that's not guarantee payment. We will pay up to $6600 for the calendar year and that's for all covered benefits, and physical therapy does fall under outpatient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] [PII], sorry, wait, stop, stop, stop you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Every, yeah, the call is breaking up like it's coming in and out so after you said the $6600 I don't know what you said.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] OK, I'm sorry.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK. The plan does cover physical therapy.
[AGENT][NEUTRAL] And we pay up to $6600 for all covered outpatient services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so.
[AGENT][NEUTRAL] So physical therapy does fall under that.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, yes.
[CUSTOMER][NEUTRAL] Hello? I didn't hear what you said, so what?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Physical therapy does fall under outpatient.
[CUSTOMER][NEUTRAL] Right, I, I see that here on the description, um, so how does that work? Because with my primary insurance, I believe it's a $75 copay.
[CUSTOMER][NEUTRAL] So I assume it initially goes through primary first.
[CUSTOMER][NEUTRAL] Right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And then what?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, once it goes through your primary first.
[CUSTOMER][NEUTRAL] So like I pay, I pay.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] I'm sorry, can I call you right back? I'm not sure what the connection is. Can I call you right back on your callback number, please?
[CUSTOMER][NEUTRAL] Uh, can I give you a different callback number? Sorry.
[AGENT][NEUTRAL] Oh, sorry, yes, of course.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] OK, let me call you right back, OK?
[CUSTOMER][POSITIVE] OK thanks.
[AGENT][POSITIVE] OK, thanks.