AccountId: 011433970860
ContactId: fe01d3b8-298a-4bf6-8737-8cec3c7b4415
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190320 ms
Total Talk Time (AGENT): 73161 ms
Total Talk Time (CUSTOMER): 74970 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/fe01d3b8-298a-4bf6-8737-8cec3c7b4415_20250430T19:30_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, [PII], my name is [PII]. I'm calling from Northwestern Medicine. I'm just checking on benefits for a patient, uh, for physical therapy.
[AGENT][POSITIVE] I'd be happy to assist with benefits today, [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] 02463266.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII].
[AGENT][NEUTRAL] And I do show the physical therapy is covered under the outpatient benefit. Outpatient calendar year maximum is.
[AGENT][NEUTRAL] $1000. Let me see if he's used any.
[AGENT][NEUTRAL] Um, looks like they haven't used any benefits so far this year. They have the full amount available.
[CUSTOMER][NEUTRAL] So give me a little bit of information on this type of policy if you would please. I'm not familiar with it so.
[CUSTOMER][NEUTRAL] Is this in addition to her primary insurance? Can you share a little bit about this type of policy?
[AGENT][NEUTRAL] Yes, we're the gap
[AGENT][NEUTRAL] We're a gap policy, so you would bill the primary first and then once they send you back the claim and the EOB then you would um bill us and send us the EOB for processing.
[CUSTOMER][NEUTRAL] A gap policy, OK.
[CUSTOMER][NEUTRAL] OK. And did you say it was $1000 max?
[AGENT][POSITIVE] Per calendar year, that's correct.
[CUSTOMER][NEUTRAL] And um is that just for physical therapy or is it combined with other therapy?
[AGENT][NEUTRAL] It's any outpatient for the calendar year.
[CUSTOMER][NEUTRAL] Oh, any type of outpatient service, OK.
[CUSTOMER][NEUTRAL] Does it follow kind of the same as like a calendar year um benefit time frame?
[AGENT][NEUTRAL] Yeah, it's calendar year.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Um, that should be all I need.
[CUSTOMER][NEUTRAL] Is there anything else that you would want me to be aware of for this type of policy?
[AGENT][NEUTRAL] Um, no.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we, we, we operate.
[CUSTOMER][NEUTRAL] Do we know if she's used any of her.
[AGENT][NEUTRAL] No, I said that she hadn't used any she has the full amount available.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] But we, we operate the same as any other gap policy.
[CUSTOMER][POSITIVE] Understood thank you.
[CUSTOMER][POSITIVE] OK. All right. Well, thank you so much. Um, do you provide a reference number?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][POSITIVE] No, thank you so much. Have a good day.
[AGENT][POSITIVE] Thank you for calling APL have a good day.
[CUSTOMER][POSITIVE] Thanks. Bye bye.