AccountId: 011433970860
ContactId: c5d9390d-dfe1-44b8-b0b9-7914a8bc8ecb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305489 ms
Total Talk Time (AGENT): 146885 ms
Total Talk Time (CUSTOMER): 84546 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/c5d9390d-dfe1-44b8-b0b9-7914a8bc8ecb_20250514T14:28_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, good morning, [PII]. My name is [PII], and I'm calling from Select Physical Therapy down in [PII], and I was wondering, I just need to check on a patient's benefits through APL using this as a secondary plan to UHC.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII]. So you're just needing, do you need eligibility as well or just benefits?
[CUSTOMER][NEUTRAL] Yeah, I'll take eligibility as well, please.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII].
[CUSTOMER][NEUTRAL] It is 963-229-881.
[AGENT][NEUTRAL] OK, now that is not an APO policy number.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, I'm sorry, uh, I read the wrong line 1045906 M as in Mike L as in Larry, number 4.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide today will be a verification of benefits and not a guarantee of payment. What is your patient's name please and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][NEUTRAL] OK, thank you. Now, she is a subscriber, however, the policy number that you gave me is an old policy number that turned back to one of 18.
[AGENT][NEUTRAL] She has another policy that's active, and the current active policy number is 01480315. That policy went into effect to [PII] and is still currently active.
[CUSTOMER][NEUTRAL] Oh wow, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, now is this, let me pull up some additional information.
[CUSTOMER][NEUTRAL] And to confirm that policy number was 0140315.
[AGENT][POSITIVE] That is correct. Mhm.
[CUSTOMER][POSITIVE] OK thank you appreciate it.
[AGENT][POSITIVE] You're welcome. Yeah, sure.
[CUSTOMER][NEUTRAL] Is there, is there a group number on that plan too, or?
[AGENT][NEUTRAL] I don't believe her group number changed. It would have been the same, uh, but it's 15494.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK. So is this going to be done at a physical therapy facility?
[CUSTOMER][NEUTRAL] Uh, yeah, we, we bill this office, but yes, physical therapy.
[AGENT][NEUTRAL] OK, so depending on.
[AGENT][NEUTRAL] So what's the place of service?
[CUSTOMER][NEUTRAL] We use office office setting.
[AGENT][NEUTRAL] OK, so office visits and treatment done within an office setting are not covered under this supplemental policy.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] She does, and that's why I asked if it was a facility, a physical therapy facility, this billing of facility.
[AGENT][NEUTRAL] That is a
[CUSTOMER][NEUTRAL] Yeah, we don't
[AGENT][NEUTRAL] Yeah, if it's
[CUSTOMER][NEUTRAL] Yeah, we don't build. The only place we bill is facilities Blue Cross plans, all the others we bill is office settings, so.
[AGENT][NEUTRAL] OK. So under this plan, uh, OK. So under this plan for office visits or treatment done in an office setting, that is not covered.
[CUSTOMER][NEUTRAL] Not sure why, but that's what we do.
[CUSTOMER][NEUTRAL] Not covered. OK. Not a problem. Um, can I just get a uh call reference number from you then, please?
[AGENT][POSITIVE] Correct. OK.
[AGENT][NEUTRAL] Absolutely you would use my name along with today's date and then um in the future if you all ever file a claim with us, said [PII] for a member, we do have a portal that you should be able to check claim status in once it's been processed and the website for our portal is secured. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect. And then uh what was your first name again? I'm sorry.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], OK, thank you, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, excellent thank you so much for your help.
[AGENT][POSITIVE] OK, well, you're very welcome and so again if that is all I could help you with, [PII], thank you for calling APO and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.