AccountId: 011433970860
ContactId: ca0e36bb-66a9-43b0-9932-cb82b01c9d99
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229029 ms
Total Talk Time (AGENT): 113879 ms
Total Talk Time (CUSTOMER): 49457 ms
Interruptions: 1
Overall Sentiment: AGENT=2.3, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/ca0e36bb-66a9-43b0-9932-cb82b01c9d99_20250228T19:30_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for, I'm sorry, good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hi, I am needing to get eligibility and benefits for a patient please.
[AGENT][POSITIVE] It would be my pleasure to assist you. May I ask your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you, [PII] and a good call back number?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] It is 01841268.
[AGENT][NEUTRAL] Thank you, [PII], and the patient's name and date of birth?
[CUSTOMER][NEUTRAL] That is for [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you, and it would be my pleasure to help you with that eligibility and benefits for [PII]. I'm showing that his policy is active. Effective date is [PII]. This is a secondary policy to his primary insurance and all benefits given over the phone is a verification of coverage, not a guarantee of payment.
[AGENT][NEUTRAL] And what type of benefits are you needing, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] This is for physical therapy in the hospital setting.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, he is.
[AGENT][NEUTRAL] Is he inpatient?
[CUSTOMER][POSITIVE] Um, outpatient, I'm sorry.
[AGENT][NEUTRAL] Outpatient. OK, thank you. He does have outpatient coverage up to $2000.
[AGENT][NEUTRAL] Her calendar day.
[AGENT][NEUTRAL] Now there is a $2000 deductible on this policy and once that deductible is met, then the benefit amount is $2000.
[AGENT][NEUTRAL] I'm checking to see if he's met his deductible for 2025.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That is a per calendar day benefit.
[AGENT][NEUTRAL] I'm checking on his, bear with me just one second.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Let me see if that's a per calendar day deductible.
[AGENT][NEUTRAL] Let me get that policy pulled up because I don't want to give you incorrect information. Bear with me just one second.
[CUSTOMER][POSITIVE] Sure, not a problem.
[AGENT][NEUTRAL] It is a 250 per calendar day deductible.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the benefit is.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] $2000 per calendar day and then the there is a $250 daily uh $250 deductible per calendar day as well. Well, that was hard.
[CUSTOMER][NEUTRAL] OK, yep.
[CUSTOMER][NEUTRAL] It's OK, it's a Friday afternoon. We're almost done with this.
[AGENT][NEUTRAL] It's, I got, I got Friday tongue. It's just.
[CUSTOMER][NEUTRAL] Yeah, it's OK.
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] I got where you were coming from, so yeah.
[AGENT][POSITIVE] I appreciate that. Anything else I can help you with?
[CUSTOMER][POSITIVE] All right, well, thank you.
[CUSTOMER][POSITIVE] No, that's exactly what I needed.
[AGENT][POSITIVE] Well, thank you for calling APL. I hope you have a wonderful day and thank you, have a great weekend.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Yes thank you you too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][POSITIVE] All right thanks bye.