AccountId: 011433970860
ContactId: ec2a6035-50f7-424b-a427-c0a5d8c1cabc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283630 ms
Total Talk Time (AGENT): 76667 ms
Total Talk Time (CUSTOMER): 135945 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/ec2a6035-50f7-424b-a427-c0a5d8c1cabc_20250620T17:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, hi, I'm calling to find out benefits for a patient for physical therapy. I'm calling from Select Physical Therapy.
[AGENT][POSITIVE] OK, I can help you with benefits. Could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Um, my name is [PII], and the uh number is [PII] and what is your name, ma'am?
[AGENT][NEUTRAL] Um, it's [PII].
[CUSTOMER][POSITIVE] Uh thank you, [PII].
[AGENT][NEUTRAL] OK, [PII], do you have the policy number for that patient?
[CUSTOMER][NEUTRAL] Yes, um, and this is for outpatients, so the number would be 02538440 ML8.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] It looks like this in [PII], but they've got a more recent policy. Let me pull that up.
[AGENT][POSITIVE] OK. Uh, this policy is effective.
[AGENT][NEUTRAL] [PII]. Let me give you that number. Um, it's 255.
[AGENT][NEUTRAL] 5
[CUSTOMER][NEUTRAL] Oh, the, so, so it's, it's a different policy number?
[AGENT][NEUTRAL] Yes, that's
[CUSTOMER][POSITIVE] Oh, thanks for giving me. So what is it? 255.
[AGENT][NEUTRAL] 652-2.
[CUSTOMER][NEUTRAL] 652-2. So is that the 02538440 ML 8?
[AGENT][NEUTRAL] Right, that's their old policy number.
[CUSTOMER][NEUTRAL] So 255-6522 no 01 or nothing out at the beginning or nothing.
[AGENT][POSITIVE] Uh, correct.
[AGENT][NEUTRAL] And then you
[CUSTOMER][NEUTRAL] A group number?
[AGENT][NEUTRAL] Uh, group number is
[AGENT][NEUTRAL] 80094.
[CUSTOMER][NEUTRAL] 80094. I'm gonna have to tell him to bring me that new card. I and you said this policy was effective [PII]. He gave me the old insurance card, OK, so 80094 and let's see, and what does it cover for physical therapy?
[AGENT][NEUTRAL] Um, for physical therapy is not a guarantee of payment, basic outline of the policy. Uh, plan covers 8700 per calendar year. We'll pay up to that amount.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Covers.
[CUSTOMER][NEUTRAL] 8000 what?
[AGENT][NEUTRAL] 700
[CUSTOMER][NEUTRAL] For calendar year?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For physical therapy, OK. And um, so, and no co-payments or nothing, just it covers $8700 per calendar year, that's it, right? Does it um does it pick up on co-payments and deductibles and co-insurance?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, it's a secondary gap policy, yes.
[CUSTOMER][NEUTRAL] OK. So it's um it's OK.
[CUSTOMER][NEUTRAL] It is exactly the APL secondary gap.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Let me see. Anything else that I should know about this plan?
[AGENT][NEUTRAL] Um, not, not that I can think of. We just need the primary EOB when you file the claim.
[CUSTOMER][POSITIVE] Perfect
[CUSTOMER][NEUTRAL] Which is him, right? [PII]?
[AGENT][NEUTRAL] And we need the primary explanation of benefits from his primary insurance when you file the claim.
[CUSTOMER][POSITIVE] OK, OK, so I got here 255652-280094, the group number. OK, thank you very much for the um the help um.
[CUSTOMER][NEUTRAL] And um could I have a call reference number?
[AGENT][NEUTRAL] A call reference number is my name, [PII]. First initial [PII] name, [PII], and today's date. And anything else I can help with today?
[CUSTOMER][NEUTRAL] That's it. So 8700 per calendar year, it'll cover um deductible and co-insurance or whatever he has, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] On the primary? On the primary?
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][POSITIVE] OK, thank you very much, [PII]. Have a wonderful day. Bye-bye.
[AGENT][POSITIVE] OK, thanks for calling APL. You too. Bye bye.