AccountId: 011433970860
ContactId: c72d926e-3952-4f29-97ee-5ea7573d89f8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210970 ms
Total Talk Time (AGENT): 86627 ms
Total Talk Time (CUSTOMER): 72310 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/c72d926e-3952-4f29-97ee-5ea7573d89f8_20250610T15:01_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII].
[CUSTOMER][NEUTRAL] Um, yes, I can hear you, but I can't really understand you too well.
[AGENT][NEUTRAL] OK, my name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, yes, I'm calling to check eligibility and benefits for a member for um outpatient physical therapy.
[AGENT][NEUTRAL] OK, may I have your name please? I can help you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. What is the policy number?
[CUSTOMER][NEUTRAL] 026 09968
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Let me just repeat that to you. I have that as 2609968.
[CUSTOMER][NEGATIVE] Oh no, yeah.
[CUSTOMER][NEUTRAL] 0 in front of the 2.
[AGENT][NEUTRAL] OK, verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], and that is [PII].
[AGENT][POSITIVE] OK, thank you so much. And you're calling for physical therapy benefits. Give me one moment, I can get that to you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. The member shows effective as of [PII]. Policy shows active and for a physical therapy, bear with me, please.
[AGENT][NEUTRAL] OK. Please note verification of benefits provided does not guarantee payment.
[AGENT][NEUTRAL] We pay a benefit up to $6000 for the calendar year and physical therapy is covered, um, it cannot be related to.
[AGENT][NEUTRAL] Occupational therapy, but it is physical therapy is covered.
[CUSTOMER][NEUTRAL] OK, physical therapy.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So up to $6000 you guys cover so that includes deductible or co-pays from the primary insurance.
[AGENT][NEUTRAL] We do help with the deductible, copay and co-insurance for the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and have they using their um their amount already or?
[AGENT][NEUTRAL] Let me check that for you one moment please.
[AGENT][NEUTRAL] He has not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, so
[CUSTOMER][NEUTRAL] Alright, so then if they have a copay that picks up until that $6000 is exhausted, correct?
[AGENT][NEUTRAL] For all outpatient services covered outpatient services, we pay up to $6000 has been exhausted.
[CUSTOMER][NEUTRAL] OK good alright and what is your name again?
[AGENT][NEUTRAL] My name is [PII] and my last initial is [PII]. Anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] Um, I think that that's good. I got the number. I've got the um claims address and everything. And when does this turn?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Are it is it does it renew or like term at um at the end of the year or?
[AGENT][NEUTRAL] Well, it shows that the policy is currently active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, and I just need a reference number, [PII], please.
[AGENT][NEUTRAL] OK, we do not provide reference numbers, but you can use my name and today's date please, [PII] thank you.
[CUSTOMER][POSITIVE] Sounds good thank you very much have a great day.
[AGENT][POSITIVE] You as well. Thanks for calling APL. Take care, bye.
[CUSTOMER][NEUTRAL] You too. Bye.