AccountId: 011433970860
ContactId: eb9a7c20-2e0a-4396-9312-ced1f04a6829
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 389489 ms
Total Talk Time (AGENT): 126929 ms
Total Talk Time (CUSTOMER): 106241 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/eb9a7c20-2e0a-4396-9312-ced1f04a6829_20250602T20:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] with Bates County Memorial Rehab, and um we have a patient that has your company as a secondary insurance. I was just wanting to verify eligibility.
[CUSTOMER][NEUTRAL] Benefits.
[AGENT][NEUTRAL] OK, I can hear you. Yes, I can help you with both eligibility and benefits. Um, can I get your callback number, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And then what is the member's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] It is [PII] [PII].
[CUSTOMER][NEUTRAL] And his policy number is 01835971.
[AGENT][NEUTRAL] OK, let me look him up real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, I do show that [PII] does have an active policy. His effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is a supplemental insurance policy. It's billed secondary to the primary.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is just to verify his benefits. It's not a guarantee of payment. It helps with deductible, co-pay, and co-insurance.
[AGENT][NEUTRAL] He has an inpatient account here benefit amount of $1500.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then he also has an outpatient calendar year benefit amount of the same of $1500 to help with.
[AGENT][NEUTRAL] Deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK, this will be for outpatient hospital physical therapy, so should that be a covered benefit? OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me look and see if he has PT on it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Policy
[CUSTOMER][NEUTRAL] [PII] I have an [PII]
[AGENT][NEUTRAL] I need to pull in his policy certificate so it's gonna be just a moment so the computer can download it for us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, and do you prefer the early morning?
[CUSTOMER][NEUTRAL] OK, I will do the best I can with that. Um, I'll go ahead and have a schedule made for you and um I'll have to put you on the wait list too.
[AGENT][NEUTRAL] takes a while for the.
[AGENT][NEUTRAL] Computer to bring it up for me.
[CUSTOMER][POSITIVE] OK, no problem.
[CUSTOMER][NEUTRAL] wait list if you get a cancellation.
[CUSTOMER][POSITIVE] That time works for you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] All right thank you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][POSITIVE] OK, it's finally starting to come in.
[CUSTOMER][NEUTRAL] YouTube videos.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, so he does have physical therapy benefits and.
[AGENT][NEUTRAL] Um, and these are the facilities that he can use?
[AGENT][NEUTRAL] A free standing outpatient surgery center, hospital emergency room, hospital outpatient facility, MRI facility, physical therapy facility, or urgent care. So yes, he does have physical therapy under his policy.
[CUSTOMER][NEUTRAL] OK, so and you said 1500, that's the maximum pays for the year and once that's used up, that's it.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, alright.
[CUSTOMER][NEUTRAL] Um, and I assume pre-authorization is not required.
[CUSTOMER][NEUTRAL] Just a claim sent in.
[AGENT][NEUTRAL] No, ma'am, because it's right, it's the uh secondary so it won't be required.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, I think uh I don't know if you just have a reference number for the call, that's all I need.
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] You're welcome, Ms. [PII]. Is that everything I can help you with?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, well you have a great night and thanks for calling APL.
[CUSTOMER][NEUTRAL] Uh, yeah, yeah, me too.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Oh, it probably could interfere with.
[CUSTOMER][NEUTRAL] I mean solar flares do that so I'm now.