AccountId: 011433970860
ContactId: c81afc48-e923-406a-a174-7640a28d2868
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290100 ms
Total Talk Time (AGENT): 105335 ms
Total Talk Time (CUSTOMER): 80516 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/c81afc48-e923-406a-a174-7640a28d2868_20250127T21:23_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, uh, good afternoon. Uh, my name is [PII], and I'm calling from Performance Therapeutics Physical Therapy office in regards to this patient. Um, I just wanted to see, um, if this patient's, uh, account is active.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, sure. I can assist you with the eligibility. And may I have your name?
[CUSTOMER][NEUTRAL] Yes, uh, [PII].
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnect them of course.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, uh, let's see here it is.
[CUSTOMER][NEUTRAL] Policy number 01868817.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[AGENT][NEUTRAL] And what's her date of birth?
[CUSTOMER][NEUTRAL] Date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect, thank you. And you say you need eligibility today, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. All right, we have, let's see, an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plans to the major medical.
[CUSTOMER][NEUTRAL] OK, so it is a supplementary.
[AGENT][NEUTRAL] Mhm. That's a secondary supplemental plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I was also wondering, does that cover copay for the patient?
[AGENT][NEUTRAL] For an office visit? Oh you said it was physical therapy, correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, let me check and see. One moment, let me pull that.
[AGENT][NEUTRAL] Breakdown benefits.
[AGENT][NEUTRAL] OK, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer and I'm waiting on the documents to pull up, bear with me.
[CUSTOMER][POSITIVE] No problem.
[AGENT][POSITIVE] Mm thank you.
[AGENT][NEUTRAL] All right, um.
[AGENT][NEUTRAL] Mm. Yes, OK. So yes, physical therapy is part of that payment, part of that benefit, I'm sorry, and that will be uh outpatient and that's $2550 per covered person per calendar year. We do cover co-payments, co-insurance and deductibles from the major medical.
[CUSTOMER][NEUTRAL] OK, so you do cover co-payment and co-insurance.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me just go ahead and write this down, give me one moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, and I have one more question um if the patient has a deductible um in their primary insurance, do they have to meet that deductible first?
[AGENT][NEUTRAL] No, that's what we're here for.
[CUSTOMER][NEUTRAL] Ah, OK, OK.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes ma'am, so sorry, I was writing that down, um, and so may I get your name and a reference number please?
[AGENT][NEUTRAL] My name is [PII], and we don't have reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, looks like I've got everything.
[AGENT][NEUTRAL] OK, Ms. [PII], is there anything else I'm gonna help you with today?
[CUSTOMER][NEUTRAL] No, that'll be all.
[AGENT][POSITIVE] Yeah, well, thank you for calling APL. Have a good day, sir.
[CUSTOMER][POSITIVE] Thank you likewise.
[AGENT][POSITIVE] Mm thank you. Mm bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.