AccountId: 011433970860
ContactId: d38844e8-b74f-4254-88f8-eed3fd31cd20
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203649 ms
Total Talk Time (AGENT): 62307 ms
Total Talk Time (CUSTOMER): 89264 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/2025/05/08/d38844e8-b74f-4254-88f8-eed3fd31cd20_20250508T14:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I need to um check for eligibility and benefits for a member please.
[AGENT][NEUTRAL] OK. Can I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Yes, [PII] last initial [PII] [PII].
[AGENT][NEUTRAL] OK, thank you, [PII], and you have the.
[CUSTOMER][NEUTRAL] And your name
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] I'm sorry, your name was [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Oh [PII], OK, thank you.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh, do you have that policy number, [PII]?
[CUSTOMER][NEUTRAL] I do uh 02369466.
[AGENT][NEUTRAL] OK, thank you. And the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, I've got this policy effective [PII]. It is currently active.
[AGENT][NEUTRAL] And is this gonna be for outpatient benefits?
[CUSTOMER][NEUTRAL] Yes, outpatient, uh, physical therapy.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Let me get that policy pulled up and this is.
[CUSTOMER][NEUTRAL] And this will
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] OK, this will be done in the outpatient um hospital setting and everything will be billed by the facility.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] Uh, and this is not a guarantee of payment. It's a basic outline of his policy.
[AGENT][NEUTRAL] Uh, for outpatient services, um, this is a secondary policy, so it'll pick up after primary processes the claim. It'll pick up up to 3000 per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, 3000 per individual per calendar year.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so that automatically picks up what um his primary insurance does not cover up to $3000.
[AGENT][NEUTRAL] Yes, it'll pick up any deductible or co-insurance or co-pay.
[CUSTOMER][NEUTRAL] Oh, OK, so there is no uh uh.
[CUSTOMER][NEUTRAL] Co-pay or deductible with this actual policy, it's just a secondary.
[AGENT][POSITIVE] Yes, that's correct. It's just a benefit payable of 3000. Yeah.
[CUSTOMER][NEUTRAL] Oh, OK, OK, I see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, I believe then that that is all um the information that I need for the um eligibility and benefits. May I get a reference number for this call please?
[AGENT][NEUTRAL] Uh yes, it's just my name, [PII], first initial to last name [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you very much I appreciate your assistance.
[AGENT][POSITIVE] Thanks for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Thank you you as well.
[AGENT][POSITIVE] Thank you. Bye-bye.