AccountId: 011433970860
ContactId: dd44d3dd-844f-4caf-8936-5a3fbe87ffdb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 166380 ms
Total Talk Time (AGENT): 78322 ms
Total Talk Time (CUSTOMER): 52317 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/dd44d3dd-844f-4caf-8936-5a3fbe87ffdb_20250102T18:43_UTC.wav
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[CUSTOMER][NEUTRAL] Ah, in ER.
[AGENT][NEUTRAL] For calling APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I'm calling from Dural Physical Therapy. Um, I'm just calling to confirm a patient's, um, coverage and benefits and their eligibility date. If you could please help me out with that, that'd be great.
[AGENT][POSITIVE] Of course I can check eligibility and benefits for you, [PII]. Uh, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it is [PII] and that is a direct line.
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, I have um outpatient benefits certain number. I'm looking at the card, right? That's what you're looking for?
[AGENT][POSITIVE] Yes, yes, please.
[CUSTOMER][NEUTRAL] Yeah, so it is 02446027 ML 8.
[AGENT][NEUTRAL] OK, thank you and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] OK perfect thank you for verifying that [PII]. uh, so this policy is active effective date was [PII].
[AGENT][NEUTRAL] And what uh where we just needed to look at outpatient benefits?
[CUSTOMER][POSITIVE] Uh, physical therapy benefits.
[AGENT][NEUTRAL] Physical therapy. OK. One moment, please.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims, so physical therapy performed in a physical therapy facility is covered under their outpatient benefit. Uh, that benefit amount is on a per calendar day basis, so it is $250 max per calendar day.
[CUSTOMER][NEUTRAL] Is there in a yearly maximum or no?
[AGENT][NEUTRAL] No, it it's just on a per calendar day basis, no yearly marks.
[AGENT][NEUTRAL] It is very dependent on major medical though, as long as major medical uh contributes this policy can if major medical does not pay, this policy can't.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Got it. OK.
[AGENT][NEUTRAL] Alright, anything else I can help you with?
[CUSTOMER][POSITIVE] Sounds good. Can I just get your name and a reference number for this call, please?
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. And my name is spelled [PII]
[CUSTOMER][POSITIVE] I got it. Thank you so much. You have a great day, [PII].
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. You too, thanks bye bye.
[CUSTOMER][NEUTRAL] Bye.