AccountId: 011433970860
ContactId: e440f3e1-58fe-40ac-a670-209fccb7a6e3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 153479 ms
Total Talk Time (AGENT): 69215 ms
Total Talk Time (CUSTOMER): 74586 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/e440f3e1-58fe-40ac-a670-209fccb7a6e3_20250213T13:50_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from provider's office to check on the business benefits.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Oh yes, callback number [PII] with no extension and the policy number is Shallus. Um, it's gonna be, one moment, ma'am.
[CUSTOMER][NEUTRAL] It's, it's 02424711, M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] Thank you, [PII]. Could you verify the patient's name and date of birth, and I'll be able to assist you.
[CUSTOMER][NEUTRAL] [PII] of [PII].
[AGENT][NEUTRAL] You're calling to verify benefits eligibility for what place of service?
[CUSTOMER][NEUTRAL] Um, it's gonna be the um outpatient hospital facility and uh I I need to know some specific benefits, by the way.
[AGENT][NEUTRAL] This member's policy has, this is a gap insurance.
[AGENT][NEUTRAL] That assists with deductible, co-pay and co-insurance for the primary.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The member has outpatient benefits of $5500 per calendar year and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK, ma'am. Actually, the, the, the, this patient primary insurance is uh BCBS and it, it has a co-pay of uh co-pay of something, some amount of $80. And may I know if it is covered?
[CUSTOMER][NEUTRAL] 80 $80 is covered by the.
[AGENT][NEUTRAL] This policy has $55,500 per calendar year to assist with deductible, co-pay, and co-insurance for services that's covered under the policy.
[CUSTOMER][POSITIVE] Thank you so much, ma'am. And what, what
[AGENT][NEUTRAL] And this is not a guarantee of benefits, just a disclaimer of the policy's coverage, [PII].
[CUSTOMER][NEUTRAL] Got it, ma'am. And [PII] last question. And is, and the physical therapy is covered, by the way? Physical therapy evaluation is covered?
[AGENT][NEUTRAL] Could you repeat your question?
[CUSTOMER][NEUTRAL] Um, is the physical therapy evaluation is covered? Physical therapy is covered?
[AGENT][NEUTRAL] Falls under her outpatient benefits of the $5500 per calendar year. Is there anything else that I could assist you with today, [PII]?
[CUSTOMER][NEUTRAL] For the
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, yeah. Can I have the call reference number, please?
[AGENT][NEUTRAL] We don't provide those unfortunately. You can use my name in today's date as a reference. It's [PII], today's date.
[CUSTOMER][POSITIVE] So. OK, [PII]. Have a nice day.
[AGENT][POSITIVE] Thanks for calling ATL. Have a great day, [PII]. Goodbye.