AccountId: 011433970860
ContactId: f687c008-e191-47c0-ad05-abd411b8e741
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 513479 ms
Total Talk Time (AGENT): 193466 ms
Total Talk Time (CUSTOMER): 204538 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/f687c008-e191-47c0-ad05-abd411b8e741_20250409T19:12_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] It's fine.
[CUSTOMER][NEUTRAL] Uh, hi there, my name is [PII], um, part of, uh, APL.
[CUSTOMER][NEUTRAL] Here, uh, recently got diagnosed with some back trouble and I have a prescription here for physical therapy. I'm just wondering uh if you can help me find someone within.
[CUSTOMER][NEUTRAL] The APL group who I would be able to see.
[AGENT][NEUTRAL] Um, I can check and see what type of policy you have with us and how can I assist you based on your policy, Mr. [PII]. Um, may I have the callback number just in case we get disconnected?
[CUSTOMER][POSITIVE] Oh great.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] Uh, that is.
[CUSTOMER][NEUTRAL] 02595525
[AGENT][NEUTRAL] OK, thank you. For security, may I have your date of birth, mailing address and email address for verification?
[CUSTOMER][NEUTRAL] Uh, what was the first one?
[AGENT][NEUTRAL] Date of birth, mailing address and email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My address is [PII].
[CUSTOMER][NEUTRAL] And my email is [PII].
[AGENT][POSITIVE] Yes, thank you. OK, let me look at your benefits really quick, one moment.
[AGENT][NEUTRAL] OK. Um, so the particular um product that you have is a limited hospital indemnity plan. And this one, doesn't really have a network. You can choose to go to any physical therapy office that you would like, um, because there's no network. Now, if you don't know exactly where to go.
[AGENT][NEUTRAL] Um, if you just need a list of providers for the physical therapy in your area, um, you can go ahead and go to [PII] and you can check, um, and see what physical therapist's office you have around you. But if, uh, they already gave you a um prescription, more than likely they already send you to somebody, did they?
[CUSTOMER][NEUTRAL] Yeah, so they gave me a list of people in my neighborhood, but I don't know if they're going to accept APL.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right? Because not everybody is going to accept that.
[AGENT][NEUTRAL] Correct, yes. Now, we don't determine that. They determine that because there's no network.
[CUSTOMER][NEGATIVE] There is no network, so is this would I pay out of pocket for this and then get reimbursed? That's what I had to do with the doctor visit.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] You can if.
[CUSTOMER][NEUTRAL] Uh, how does physical therapy work?
[AGENT][NEUTRAL] OK, just in any case, if they don't take the card, yes, you can pay out of pocket and we'll go ahead and send your reimbursements once you send the claim. I can go ahead and give you your benefit, um, the benefit amount, and this is not a guarantee of payment, just a verification of coverage. We cover $30 per day up to a maximum of 4 days per year.
[CUSTOMER][NEUTRAL] OK, so if this description says 6 weeks of physical therapy once to twice a week, you only pay for 4 of those and I would pay for the rest.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Mm correct.
[CUSTOMER][NEUTRAL] And would I get reimbursed?
[AGENT][NEUTRAL] If you send your claim, we can reimburse you the $30 per day up to 4 days, correct.
[CUSTOMER][NEUTRAL] No, no, no, more than 4 days. Let's say I go 20 times and then I submit a claim for those.
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] The, mm mm, the policy only pays for per year.
[CUSTOMER][NEUTRAL] 4 physical therapy visits a year.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh-huh. Uh, OK. Um, do you have a list of
[CUSTOMER][NEUTRAL] Therapy places near me I can go to?
[AGENT][NEUTRAL] I don't have one per se that we um use, but I can go to multiplan and give you a couple of them if you would like me to give you some over the phone or you can go to [PII] and you can use that tool to find one.
[CUSTOMER][NEUTRAL] I'm there right now.
[AGENT][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] I am here right now. I just typed in physical therapy.
[CUSTOMER][NEUTRAL] I guess it's looking.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's spinning around.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, type in physical therapy and my zip code.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, so in this list.
[CUSTOMER][NEUTRAL] Cause that happened when I was trying to find a primary doctor. There was a whole bunch of names on this website, and I would call them and I'm part of APL. They said, we've never heard of that. Sorry.
[CUSTOMER][NEUTRAL] So is everyone in this list?
[CUSTOMER][NEUTRAL] For physical therapists, they're part of APL, uh, part of this multi-plan PPO. What, what is it that I tell them when I call? Is it multi-plan PPO or APL?
[AGENT][NEUTRAL] It's gonna be APL uh because there's no network. The multiplan is just a tool to use to find somebody in your area, so it's not really that we're contracted with multiplan, no, we are APL so it is gonna be through APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so when I call one of these places I'll ask do you.
[CUSTOMER][NEUTRAL] Are you part of APL?
[AGENT][NEUTRAL] Mhm. Or do you take APL?
[CUSTOMER][NEUTRAL] And it.
[CUSTOMER][NEUTRAL] Do you take APL and uh
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] If they do, I can go there 4 times, you see.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh-huh, um.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][POSITIVE] All right, there's a pretty good list here. Uh, OK, I will try this out and uh thank you for your time. I appreciate it.
[AGENT][POSITIVE] You're welcome. No problem. Is there anything else I may help you with today? Any other questions or concerns, Mr. [PII]?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, not at the.
[CUSTOMER][NEUTRAL] Not at the moment. Well, the doctor I had to see, I'm still waiting for some information to submit the claim. That doctor visit was $500. Is that something APL is going to cover?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Uh, was it a regular office visit?
[CUSTOMER][NEUTRAL] Yes, so it's a.
[CUSTOMER][NEUTRAL] Uh, a spine specialist.
[AGENT][NEUTRAL] OK, um, let me.
[CUSTOMER][NEGATIVE] For the problem I'm having.
[AGENT][NEUTRAL] Let me give you the benefits that you have on office visit. Um, the benefit on office visit is $50 per day, maximum of 4 days.
[CUSTOMER][NEUTRAL] Uh huh, so that's $500 you're only gonna cover.
[CUSTOMER][POSITIVE] 50. 0, here's the fine place they're calling me. Let me take this. Thank you for your time. I appreciate it.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Thanks bye.
[AGENT][POSITIVE] You're welcome bye bye.