AccountId: 011433970860
ContactId: 01037cf3-c3ca-47ff-946b-c418ba6876f6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 162419 ms
Total Talk Time (AGENT): 92499 ms
Total Talk Time (CUSTOMER): 49437 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/01037cf3-c3ca-47ff-946b-c418ba6876f6_20250321T19:01_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] Hi, my name is [PII]. I'm calling from Cranial Technologies, um, provider's office trying to get some benefit information for a patient.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with that benefit information. What is a good callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Is that the benefit cert number?
[AGENT][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] OK. uh 025-09922 M as in Mary, L as in Lima 8.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] All right, thank you. And it would be my pleasure to assist you with benefits for [PII]. I'm showing that this policy is active. Effective date is [PII].
[AGENT][NEUTRAL] And this is a secondary policy to the policyholder's major medical. Are there specific benefits you're needing?
[CUSTOMER][NEUTRAL] I should be for DME. I can give you a code if you need that.
[AGENT][NEUTRAL] He does have DME coverage. That benefit amount is up to $750 per calendar day that we can pay toward his deductible, co-pay, or co-insurance of the major medical, and that is a verification of coverage, not a guarantee of payment. Anything else I can help you with?
[CUSTOMER][NEUTRAL] Is there any um separate authorization requirements or just requires the primary claim once billed?
[AGENT][NEUTRAL] Just, yeah, just the primary EOB.
[CUSTOMER][NEUTRAL] OK, and then I only have the member's front of the card. Is there a claims address I can get?
[AGENT][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] City.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] All right, and then do you offer call reference numbers?
[AGENT][NEUTRAL] Call reference number would be my name and today's date. I spell my name [PII]
[AGENT][NEUTRAL] First initial last name, [PII].
[CUSTOMER][POSITIVE] All right perfect thank you so much for your help.
[AGENT][POSITIVE] And my pleasure to assist you with that benefit today, [PII]. Thank you for calling APL. Hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] Thanks you as well bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.