AccountId: 011433970860
ContactId: ec145cb2-65eb-4d31-8b58-b72511826bf4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202869 ms
Total Talk Time (AGENT): 88868 ms
Total Talk Time (CUSTOMER): 94858 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/ec145cb2-65eb-4d31-8b58-b72511826bf4_20250110T17:46_UTC.wav
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[AGENT][NEUTRAL] Calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I have a question. Um,
[CUSTOMER][NEUTRAL] You guys re does my policy reimburse therapy. I have a co-payment for therapy for $60.
[AGENT][NEUTRAL] Because I have a policy number and I can't answer it just right off. I need a policy to pull it up to verify what type of policy you have because your policy may not cover it.
[CUSTOMER][NEUTRAL] And I don't know
[CUSTOMER][NEUTRAL] Sure. I have a group number of 15493.
[AGENT][NEUTRAL] I need a policy number please if you don't mind, the policy number it should say inpatient or outpatienter number on the card, it is the policy number.
[CUSTOMER][NEUTRAL] Yeah, I have a certain number 02465617 ML7 is in hospital benefit. I have an outpatient benefit.
[AGENT][NEUTRAL] Can I have your name, address and name, mailing address, and your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And you saw that [PII] and my date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So [PII], let me give you the correct policy number. Let me know when you're ready for work.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] It is 2502651. That's 2502651.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And you're calling in regards to physical therapy. So let me make sure that your callback number is [PII].
[CUSTOMER][NEUTRAL] That is my correct callback number. I'm calling regarding therapy that my sons have received, um, through Crystal Minds. So it will be behavioral therapy and um.
[CUSTOMER][NEUTRAL] Um, just like therapy sessions.
[AGENT][NEUTRAL] So you have, you have, you don't have an office visit router. So that's not covered, however, the treatment received in the office will be covered under your outpatient benefits of $2500. So it depends on how they're coding it, but I don't see any claims on file.
[AGENT][NEUTRAL] Have they submitted any claims?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I, I don't know. Well, one of them was recent and one of them was [PII], I think. So I, I was just thinking about it now that I did the, my younger son had like two sessions. Um, I was wondering if it was something that will be covered and and that's why I was remembering.
[AGENT][NEUTRAL] Mhm. The treatment received in the office is covered and you actually had a policy since [PII], so I can barely hear you. Your phone is breaking up.
[CUSTOMER][NEUTRAL] They've been like I.
[CUSTOMER][NEUTRAL] They've been online sessions.
[CUSTOMER][NEUTRAL] Online therapy sessions, they've been video call. Does that still count?
[AGENT][NEUTRAL] Yes, you have to submit the claim so we can verify if it's covered or not, but as of right now treatment received in the office is covered on the outpatient benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's not a guaranteed benefits just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK, so I'll go.
[AGENT][NEGATIVE] Your phone is breaking up.
[CUSTOMER][POSITIVE] Thank you. I
[CUSTOMER][POSITIVE] Thank you for your help I appreciate it.
[AGENT][POSITIVE] Thanks for calling APL. Have a good day. Goodbye.
[CUSTOMER][NEUTRAL] You too bye bye.