AccountId: 011433970860
ContactId: c10ce259-71ea-4358-8b85-435290111f2d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 196899 ms
Total Talk Time (AGENT): 76215 ms
Total Talk Time (CUSTOMER): 78763 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/c10ce259-71ea-4358-8b85-435290111f2d_20250225T21:36_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. uh, I'm calling regarding one of our patients.
[AGENT][POSITIVE] OK, well, I'll be more than happy to.
[CUSTOMER][NEUTRAL] And then may I have your first initial?
[AGENT][NEUTRAL] [PII],
[CUSTOMER][NEUTRAL] Mine is [PII].
[AGENT][NEUTRAL] OK, may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII]. I have extension [PII].
[AGENT][POSITIVE] Thank you for that. And how may I assist you today, [PII]?
[CUSTOMER][NEUTRAL] I need to check uh physical therapy benefits for this patient and if there's like deductible and out of pocket maximum.
[AGENT][NEUTRAL] OK, may I have the member's policy number?
[CUSTOMER][NEUTRAL] Sure. I have 16944.
[AGENT][NEUTRAL] Is that the group number?
[CUSTOMER][NEUTRAL] That's the only information I have here. Hold on a second, let me double check, OK?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the member's first and last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, [PII]
[CUSTOMER][NEUTRAL] The last name is [PII] Robert.
[AGENT][NEUTRAL] And what's the date of birth?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So the policy number is 250.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] 5753.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And for outpatient benefits, the policy will pay up to $2500 per calendar year. That does include um physical therapy at a physical therapy facility.
[AGENT][NEUTRAL] If it is in office, there's also the office treatment rider which would uh should cover all the treatment in the office as long as it's not cosmetic and it will be up to that $2500.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so there's no deductible and out of pocket, just this $2500 correct?
[AGENT][NEUTRAL] Right, for the secondary policy, yes, we pay towards the copay, deductible and co-insurance after primary.
[CUSTOMER][NEUTRAL] Yeah. OK.
[CUSTOMER][NEUTRAL] Alrighty, thank you. So there's no such prior prior authorization and referral for this, just this 2500 maximum benefit limit.
[AGENT][POSITIVE] Right, there's no off or pre-set required.
[CUSTOMER][NEUTRAL] OK. Can you provide me uh call reference number, [PII]?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date.
[CUSTOMER][NEUTRAL] OK, that's [PII].
[CUSTOMER][POSITIVE] All right, thank you so much for your help and I appreciate it.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with?
[CUSTOMER][POSITIVE] Nothing more thank you you've been very helpful.
[AGENT][POSITIVE] All right, thanks for calling APL. You're welcome.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.