AccountId: 011433970860
ContactId: c108d128-c324-4061-9758-e526e0d4122e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 211770 ms
Total Talk Time (AGENT): 114597 ms
Total Talk Time (CUSTOMER): 57629 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/c108d128-c324-4061-9758-e526e0d4122e_20250214T15:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, Ms. [PII]. My name is [PII]. That's [PII] And I'm calling to try and verify patients benefits for physical therapy, please.
[AGENT][NEUTRAL] OK, [PII], you're needing to verify physical therapy benefits. Is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] It's going to be 2506473 M as in M as in Mike, L as in Lima, the number 8.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] And later that any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's first name is [PII]. Last name is [PII] Date of birth is [PII].
[AGENT][POSITIVE] Thank you very much. One moment.
[AGENT][NEUTRAL] Do you also need eligibility or only benefits?
[CUSTOMER][POSITIVE] El benefits both would be nice.
[AGENT][NEUTRAL] OK, sure. I can help you with both. So the the supplemental policy is active with an effective date of [PII].
[AGENT][NEUTRAL] And his outpatient benefit maximum per calendar day for covered outpatient services is $3000.
[AGENT][NEUTRAL] And there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] OK, so the patient has coverage up to $3000 per day.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] And so basically there's no visit limit for this patient?
[AGENT][NEUTRAL] There is no, no, ma'am, this is a $1 amount on the supplemental policy. And now Talita because this is a, excuse me, a supplemental policy to his primary insurance, when the claim is submitted to APL for review, we must also receive a copy of his explanation of benefits from the primary insurance along with the claim. And then once we have processed our claim, we do have a portal that you should be able to check claim status in.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] And our portal website is secured.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. And is there anything else that I can help you with this morning?
[CUSTOMER][NEUTRAL] No, I just wanted to confirm that I uh said your name correctly it was Ms. [PII].
[AGENT][NEUTRAL] That is correct and my name along with today's date to later would be your call reference number.
[CUSTOMER][POSITIVE] Thank you so very much for all your help here today. I really appreciate it. Hope you have a wonderful day. Enjoy your weekend.
[AGENT][POSITIVE] Oh, I hope, yeah, yes, ma'am, you too. I hope the same things for you and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Mm, bye-bye.