AccountId: 011433970860
ContactId: d3390d74-a80a-4940-8398-95e6f590358f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 329070 ms
Total Talk Time (AGENT): 148516 ms
Total Talk Time (CUSTOMER): 93422 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/d3390d74-a80a-4940-8398-95e6f590358f_20250502T15:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I have a question regarding my policy please.
[AGENT][NEUTRAL] OK, Miss [PII], I can help you with questions about your policy. Um, can I please get your callback number, ma'am just in.
[AGENT][NEGATIVE] Was disconnected.
[CUSTOMER][NEGATIVE] Sure, we have like a bad connection [PII].
[AGENT][POSITIVE] Thank you Mr. [PII]. Let me see if I can help that connection real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you so much. um, can you please give me your policy number?
[CUSTOMER][NEUTRAL] Sure it's 02597280 ML 8.
[AGENT][POSITIVE] OK, thank you so much and then um let me pull up this policy real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, I've got your policy pulled up. Can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] [PII] [PII] [PII].
[AGENT][POSITIVE] OK, thank you. I appreciate you verifying your policy for me, and you said you had questions. What questions do you have?
[CUSTOMER][NEUTRAL] I am doing physical therapy, so, um, I have a co-payment with my regular insurance of $80. I did provide them my gap insurance card, and they haven't asked me for a co-payment. Um, does the gap take care of that co-payment for me?
[AGENT][NEUTRAL] Right, so this policy, um,
[AGENT][NEUTRAL] And this is just to verify your benefits. It's not a guarantee of payment does help with deductible, co-pay and co-insurance only. Um, you have, uh, outpatient benefit max per calendar year of $3000 to go towards your deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEGATIVE] I because I just don't wanna, I keep going to these, I have gone to 3 and I don't wanna get a surprise that after I go to 10 and I get a huge bill, so there's no way I could find out how much of it's gonna be paid.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] Let me look and see um if your policy covers physical therapy or office visits.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm gonna pull up your policy real quick and look at it.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK, so your policy does not cover office visits.
[AGENT][NEUTRAL] It covers the treatment in the office, but not the office visit itself. And now I'm gonna check for physical therapy.
[AGENT][NEUTRAL] OK, so you're covered outpatient facility?
[AGENT][NEUTRAL] And this is just to verify your benefits it's not a guarantee of payment you're covered outpatient facility does include a physical therapy facility.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is there a maximum of of visits or does it say anything like that?
[AGENT][NEUTRAL] No, ma'am. It does not have a maximum of visits.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK, so I'm, I'm a little, so you're saying it does cover the physical therapy.
[AGENT][NEUTRAL] Yes, it does, um, for your deductible co-pay or co-insurance up to $3000 per calendar year. So the way that it works is it based on what your primary insurance, the EOB from the primary insurance would be sent to us and it'll show what your deductible co-pay or co-insurance was and then that's where this one kicks based on what your primary paid.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Got it OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for your help. All right, thank you.
[AGENT][POSITIVE] Well, you're very welcome. You're welcome. You have a wonderful weekend and thank you for calling APL.
[CUSTOMER][NEUTRAL] All right bye bye.
[CUSTOMER][NEUTRAL] You too. Bye bye.
[AGENT][NEUTRAL] Bye-bye.