AccountId: 011433970860
ContactId: 0036bbbf-9307-4d9e-a154-aa273ac00128
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 396540 ms
Total Talk Time (AGENT): 127142 ms
Total Talk Time (CUSTOMER): 180734 ms
Interruptions: 4
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/0036bbbf-9307-4d9e-a154-aa273ac00128_20250528T21:16_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, um, you said your name is [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Hi [PII], um, I'm calling to find out if my plan would cover, uh, a few things.
[AGENT][NEUTRAL] OK. And what is your name and policy number, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the policy number is
[CUSTOMER][NEUTRAL] 02608797
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Thank you. And verify the patient, or I'm sorry, verify your date of birth, mailing address and email address, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and your mailing address and email address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], did I say that already? Um.
[AGENT][NEUTRAL] You did.
[CUSTOMER][NEUTRAL] And what do you need the email address?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, it is either uh [PII].
[AGENT][NEUTRAL] No, ma'am. It's a [PII], but it's a different Gmail.
[CUSTOMER][NEUTRAL] Or the um,
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Oh, OK. [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And you say you're calling to verify benefits under the plan?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what um benefits do you need to verify? Go ahead.
[CUSTOMER][NEUTRAL] All right, so, um, I have to, I have to go to the podiatrist, OK?
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] Would would they put that would you guys cover um.
[CUSTOMER][NEUTRAL] Some medical equipment, would you consider orthotics to help with plantar fasciitis?
[CUSTOMER][NEUTRAL] Uh, medical equipment.
[AGENT][NEUTRAL] Mm, it really kind of depends on the procedure code, but let me pull up your policy. Give me one moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um let's see.
[AGENT][NEUTRAL] Uh, durable medical equipment is covered on the policy as outpatient. Um, it just would have to meet the definition, uh, definition of durable medical equipment as far as the policy.
[AGENT][NEUTRAL] But it is covered under the plan as outpatient.
[CUSTOMER][NEUTRAL] OK, so what, how would I know if that, if uh, if the orthotics are considered durable medical equipment?
[AGENT][NEUTRAL] Uh, we would need a procedure code. You can ask that from the provider and we can verify if that falls within the definition of durable medical equipment as per the plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. Um, another thing is my, my PCP had labs done for me. I had, I had to do labs at their office and um.
[CUSTOMER][NEUTRAL] I got a bill from the lab that they used to process the lab work.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] And I don't know how to, uh, to get that to you guys.
[AGENT][NEUTRAL] And was this performed in a doctor's office or in an outpatient lab facility, independent lab facility?
[CUSTOMER][NEUTRAL] I guess for the future.
[CUSTOMER][NEUTRAL] Well, the doctor's office draws the lab or the blood.
[CUSTOMER][NEUTRAL] And then Quest diagnostics processes the analysis of the blood.
[AGENT][NEUTRAL] Mhm. Uh, you do have lab, uh, independent lab facilities are covered on the policy as outpatient. As far as receiving a bill, you may need to contact that provider and let them know you have secondary insurance and they can submit the claim, or you can submit the claim by submitting the itemized bill and the primary EOB for that data service.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK. Um, my start coverage with you guys, was it in April or May?
[AGENT][NEUTRAL] [PII] of this year.
[CUSTOMER][NEUTRAL] OK, OK, alright, so I'm gonna reach out to them and tell them to please, so what do I tell them to just, um, I have to call Quest Diagnostic, the person that they, the one that send me the bill, right, or do I have to do that through my PCP?
[AGENT][NEUTRAL] Uh, you can contact Quest if they're the ones submitted the bill and just inform them that you do have secondary insurance and give them your information and then they can file the claim with our office.
[CUSTOMER][NEUTRAL] OK, alright, um.
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Let me see what else I think that's the only bill I got, OK, um, so we talked about the durable medical equipment, the lab.
[CUSTOMER][NEUTRAL] 6, 1st diagnostic bill.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, is there anything else I can assist you with? Uh, you're welcome. Thank you for calling APL. Have a great day, Ms. [PII].
[CUSTOMER][POSITIVE] That's it thank you so much.
[CUSTOMER][NEUTRAL] All right. You too, bye.
[AGENT][NEUTRAL] Bye.