AccountId: 011433970860
ContactId: cd2a1790-62f1-457f-8fa7-952db48f6481
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217139 ms
Total Talk Time (AGENT): 105389 ms
Total Talk Time (CUSTOMER): 48771 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/cd2a1790-62f1-457f-8fa7-952db48f6481_20250303T14:43_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey, my name is [PII] and I need benefits and eligibility. I'm a patient for physical therapy.
[AGENT][POSITIVE] OK, sure, I can assist you with benefits and eligibility and may I have a callback number just in case we get disconnected, mister?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Um, is 02521747.
[AGENT][NEUTRAL] OK, thank you. What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Patient is [PII], um, date of birth is [PII].
[AGENT][NEUTRAL] OK, that's independent.
[AGENT][NEUTRAL] Thank you. And let me look at the benefits. Before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. Um, we have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plans for the major medical.
[AGENT][NEUTRAL] And bear with me just one minute. I'm waiting on the benefits to pull up.
[CUSTOMER][NEUTRAL] So is this a calendar year plan?
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] It's gonna be one more minute. I'm waiting to make sure that we cover physical therapy for this member.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, yeah. OK. So yes, we do have the physical therapy added to this. So it looks like the outpatient benefit maximum is going to be $200 per person per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And is there any like deductible out of pocket that needs to be met or anything?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Not with us because we're just the secondary.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, and is there like a limit visit limit?
[AGENT][NEUTRAL] Not with us. We follow primary. So if the primary has any limits, then we're gonna go ahead and follow them. If they don't pay, let's say after they only have 10 and um he goes to 11, we, we will not pay the last one if it's not paid by the major medical. We only pay if they pay.
[CUSTOMER][NEUTRAL] No, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So there's no authorization needed?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And how do I spell your name?
[AGENT][NEUTRAL] My name is [PII], that's [PII].
[CUSTOMER][NEUTRAL] All right, and a call reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Is there anything else I can help you with today, Miss [PII]?
[CUSTOMER][POSITIVE] All right thank you.
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good week.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you, bye bye.