AccountId: 011433970860
ContactId: de4e3d30-2e94-4c85-a056-d21c46d8cd43
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 173979 ms
Total Talk Time (AGENT): 80319 ms
Total Talk Time (CUSTOMER): 83859 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/de4e3d30-2e94-4c85-a056-d21c46d8cd43_20250129T16:17_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] Hi, my name is [PII] from Baptist Health Physical Therapy. I'm calling to see if I'm trying to obtain um outpatient physical therapy benefits performed in an outpatient hospital place of service for a mutual patient of ours.
[AGENT][NEUTRAL] Sure, I can assist you with outpatient benefits, Mr. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Absolutely [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] The patient, I have the patience.
[CUSTOMER][NEUTRAL] Let me see, I have his the the payer ID is that what you mean?
[AGENT][NEUTRAL] Uh, no, it's gonna be the number in the bottom where it says outpatient start number if you have the card.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, got you, yeah, I have the card. So outpatient cert number would be 02515709 [PII] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that's L as in [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] All right. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] The name of the patient is [PII], first name [PII]. Last name [PII], that's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you. All right, let me go ahead and get the benefits for you. And 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.
[AGENT][NEUTRAL] And this is one of our secondary, I'm sorry. And this is one of our secondary supplemental plans for the major medical.
[CUSTOMER][POSITIVE] Absolutely.
[AGENT][NEUTRAL] And see, we have an outpatient maximum of 2000 per covered person per calendar year. This includes physical therapy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so with you guys up to 2000 and expenses will be covered um through you guys.
[AGENT][NEUTRAL] Correct. Um, this member has $2000 per calendar year that he can use for deductibles, co-payment, and co-insurance from the major medical.
[CUSTOMER][POSITIVE] Got you alrighty.
[CUSTOMER][NEUTRAL] And I think that's all that I should need for right now, is that correct?
[AGENT][NEUTRAL] Um, I'm not sure, but that is all the benefit information I see here for physical therapy. Is there anything else?
[CUSTOMER][NEUTRAL] There you go, yeah, that's what I figured.
[AGENT][NEUTRAL] OK, yes.
[CUSTOMER][NEUTRAL] Alright, um, so then, yeah, uh, no, that'll be all, thank you so much, um, so and then as far as visit limit and all that goes, that'll be with the primary, correct?
[AGENT][NEUTRAL] Correct, yes, that's determined by the primary. We only pay if they pay. So if they have a limit, and we have a limit.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][POSITIVE] Sounds good. All righty, thank you so much and I will go ahead and relate this to the patient.
[AGENT][POSITIVE] You're welcome, Mr. [PII], and thank you for calling ATL. Have a good day.
[CUSTOMER][POSITIVE] All right, take care. You too.
[AGENT][POSITIVE] Thank you you too.