AccountId: 011433970860
ContactId: 01627f4d-9aa8-4add-a0cb-3782ecaf3fd8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 186720 ms
Total Talk Time (AGENT): 78764 ms
Total Talk Time (CUSTOMER): 78062 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/01627f4d-9aa8-4add-a0cb-3782ecaf3fd8_20250307T19:41_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, uh, my name is [PII]. I'm with a daily medical equipment. I am needing to see about benefits, um, for a patient, um.
[AGENT][NEUTRAL] OK. Uh
[CUSTOMER][NEUTRAL] I have a policy number.
[AGENT][NEUTRAL] Yes, ma'am. Uh, what's that policy number, Ms. [PII]?
[CUSTOMER][NEUTRAL] 01792099.
[AGENT][NEUTRAL] OK, one moment, one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Oh, my thing went down.
[AGENT][NEUTRAL] OK, uh, Ms. [PII], uh, do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Uh, I sure do. [PII].
[AGENT][NEUTRAL] OK, and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Um, patient's name is [PII], and date of birth of [PII].
[AGENT][NEUTRAL] OK, um, showing his effective date is [PII]. He is active on the policy and what benefits are you needing for this patient?
[CUSTOMER][NEUTRAL] Um, durable medical equipment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it is covered under the policy as outpatient, um, not a guarantee of payment, just a verification of coverage. The patient has a benefit max up to $5000 per calendar year.
[CUSTOMER][NEUTRAL] Are you
[CUSTOMER][NEUTRAL] OK, so that's uh out of pocket, correct?
[AGENT][NEUTRAL] That's their benefit max. So after primary Insurance has processed the claim, if they apply any amount towards deductible, co-pay or co-insurance, that's what we pick up and pay up to that 5000.
[CUSTOMER][NEUTRAL] Benefit max.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK, so you pay 100% up to that amount.
[AGENT][NEUTRAL] Deductible, co-pay or co-insurance. Yes, ma'am.
[CUSTOMER][NEUTRAL] After, after, OK, OK, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and is there an authorization that's required?
[AGENT][NEUTRAL] Uh, no. Prioritization is not required.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK, alright, and um, has any of that benefit been used?
[AGENT][NEUTRAL] Uh, yes, so far he's used $405.82.
[CUSTOMER][POSITIVE] Alright perfect.
[CUSTOMER][NEUTRAL] OK, alright, if I can get a reference number that should take care of me.
[AGENT][NEUTRAL] Uh, we don't give reference numbers, but if you like, you may use my name in today's date.
[CUSTOMER][NEUTRAL] I don't.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and can you spell your name for me?
[AGENT][NEUTRAL] Yes, it's [PII] [PII].
[CUSTOMER][POSITIVE] OK, perfect. All right, thank you very much have a good day.
[AGENT][POSITIVE] Alright, you too, Ms. [PII]. Thanks for calling APL. Have a great day and weekend.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] You you too bye bye.
[AGENT][NEUTRAL] Bye.