AccountId: 011433970860
ContactId: fac94707-2c0d-43d1-9597-d1e3ea6ebc49
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 174089 ms
Total Talk Time (AGENT): 81649 ms
Total Talk Time (CUSTOMER): 49352 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/fac94707-2c0d-43d1-9597-d1e3ea6ebc49_20250428T18:44_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, I'm calling from Prisma Lawrence County Hospital in the outpatient department, and I'm trying to see if um this patient has coverage for physical therapy and if it needs pre-op.
[AGENT][POSITIVE] OK, well, I can definitely help you with the physical therapy, um, coverage and pre-op. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] My name is [PII]. Last initial is [PII]
[CUSTOMER][NEUTRAL] Phone number is [PII].
[AGENT][NEUTRAL] Thank you for that. And, may I have the member's policy number?
[CUSTOMER][NEUTRAL] 02580644
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] The number is [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] Alright, and thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. I am showing that the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And let me take a look at physical therapy benefits. Hold on one moment.
[AGENT][NEUTRAL] And this policy is a hospital indemnity policy, so it's a limited medical benefit policy. There's no coverage for um physical therapy.
[AGENT][NEUTRAL] On this policy.
[CUSTOMER][NEGATIVE] None at all. OK.
[AGENT][NEUTRAL] And I'm pulling up there.
[CUSTOMER][POSITIVE] Alrighty, thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Well, when I had called another number they said that there was like 2 policies or something on this or something, the APL and then uh.
[CUSTOMER][NEUTRAL] 90 degree or something? Do you know what that's about?
[AGENT][NEUTRAL] Hold on one second, let's see.
[AGENT][NEUTRAL] So the member has the hospital indemnity policy, which is the limited medical. So that policy itself doesn't have any network, but they also have the PPO network through multi-plan, which is 90 degree, um, but now, to like see if you all are in network with them, I can give you their phone number and their website. We just don't have access because it's a different company.
[CUSTOMER][POSITIVE] OK, I have their number thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, that'll be all thank you.
[AGENT][POSITIVE] Alright, well, thanks for calling APL. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.