AccountId: 011433970860
ContactId: f8e0e328-6cbf-480e-aeda-5f13b8a17688
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 175300 ms
Total Talk Time (AGENT): 106168 ms
Total Talk Time (CUSTOMER): 44550 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/f8e0e328-6cbf-480e-aeda-5f13b8a17688_20250304T16:42_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. I'm calling from Driven Physical Therapy, and I need to verify eligibility and benefits for a member.
[AGENT][POSITIVE] OK, [PII], I'll be glad to help you. Go ahead and give me a good policy number.
[CUSTOMER][NEUTRAL] 021 3.
[CUSTOMER][NEUTRAL] 7720
[AGENT][NEUTRAL] All right, [PII], thank you for that information and while I'm pulling this up, go ahead and give me a good return telephone call number.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, [PII], thank you for all that information. Now your patient's name and date of birth today for me, please, ma'am.
[CUSTOMER][NEUTRAL] I'm sorry, repeat that one more time.
[AGENT][NEUTRAL] Your patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Alright, thank you for that, [PII]. Looks like [PII] is the dependent spouse on this medical supplemental plan to show her original effective date. It's [PII]. She is current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim, but you did say you want PT benefits. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes, and how they apply um to as a secondary insurance.
[AGENT][NEUTRAL] All right. All right, let me get that pulled up. Let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, now, of course, what we are is her medical supplemental plan. So the only thing that we would pick up and pay on is anything for sickness or injury that is applied towards her deductible, co-pay, or co-insurance at her primary insurance carrier. If it's nothing routine, here is covered no matter what. And her outpatient physical therapy benefits here is a zero deductible, no pre-cert, and she has a $500 per calendar day benefit here.
[CUSTOMER][NEUTRAL] Uh, you said per day?
[AGENT][NEUTRAL] Per calendar day, that is correct.
[CUSTOMER][NEUTRAL] Alright and you said that you all will pick up um.
[CUSTOMER][NEUTRAL] Deductible and co-insurance.
[AGENT][NEUTRAL] Deductible co-pay or coinsurance has to be applied to one of those three things.
[CUSTOMER][NEUTRAL] For any injury.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK perfect and then if I can get a reference number.
[AGENT][NEUTRAL] Well, we don't give reference number, but you.
[AGENT][NEUTRAL] You can use my name in today's date if you need to do so, and is that all that I can help you with?
[CUSTOMER][POSITIVE] Yes, that's it. Thank you so much, [PII]. You take care.
[AGENT][POSITIVE] Yes, ma'am, you as well, [PII], thanks for calling APL. Have a good day. Bye-bye.