AccountId: 011433970860
ContactId: c9bdb1d7-d424-4f65-ac0b-bffa4691ff64
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229940 ms
Total Talk Time (AGENT): 85236 ms
Total Talk Time (CUSTOMER): 110166 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/c9bdb1d7-d424-4f65-ac0b-bffa4691ff64_20250404T15:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I was wondering if you can help me on better understand my coverage. I am covered under my husband's job as a spouse.
[CUSTOMER][NEUTRAL] And I am on his account online. I'm wondering if I need to have a separate account online.
[AGENT][NEUTRAL] Um, the only person that can have an account online is the insured.
[CUSTOMER][NEUTRAL] OK, so that's his, um, specifically, I'm looking for physical therapy, prenatal physical therapy, and I can see on the benefit form that we're covered for physical therapy.
[CUSTOMER][NEUTRAL] Um, can you help me, is there, I, on the site, there's no way to find like a physician or anything? Is that something that you can help me with?
[AGENT][NEUTRAL] Yes, um, what is the policy number?
[CUSTOMER][NEUTRAL] The policy number is
[CUSTOMER][NEUTRAL] Insured coverage group number.
[CUSTOMER][NEUTRAL] Is that the outpatient benefits certification number?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, that is 02569536 ML 8.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what was your name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. I just need to verify another piece of information. What is your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then lastly, can I get a good call back number?
[CUSTOMER][NEUTRAL] Yes, and [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, let me look at your policy and anything we discussed today is not a guarantee of payment. It's a basic outline of your policy.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so you can go to any provider you like, um, but this plan does, it does work as a secondary policy to your primary insurance.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So everything, OK, so everything has to be processed through that first. Once that processes, this will um potentially pick up any co-pay, deductible or co-insurance, but there is no network. We do not require a network.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, so it can be an out of network.
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] Um, physical therapist's office.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. So basically, most of the physical therapist offices I found don't take insurance, so essentially I would just
[CUSTOMER][NEUTRAL] Go in, pay the bill myself, and then submit a claim to my primary insurance, and if they don't cover it, APL would potentially cover.
[AGENT][NEUTRAL] Right, so, well, if, so if they don't cover it, your primary does.
[CUSTOMER][NEUTRAL] The cost.
[AGENT][NEUTRAL] They have to process the claim. It can't be a non-covered service on primary.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So yes, if if they process the claim, it's applied towards your out of network deductible, then you submit it to us, we would process it according to this policy, a physical therapy facility up to $750 per calendar day.
[CUSTOMER][NEUTRAL] OK, up to 7:50.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much. Yeah, that, that's what I wanted to know.
[AGENT][POSITIVE] OK, um, I hope you have a great anything else I can help with?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] OK thanks.
[CUSTOMER][POSITIVE] No, that's it thank you.
[AGENT][POSITIVE] Thanks for calling APL. Have a good weekend.
[CUSTOMER][POSITIVE] Thanks bye bye.