AccountId: 011433970860
ContactId: 0213d4aa-dea1-447f-b92a-3866aa34deac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203860 ms
Total Talk Time (AGENT): 96029 ms
Total Talk Time (CUSTOMER): 55968 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/0213d4aa-dea1-447f-b92a-3866aa34deac_20250127T16:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I need to verify benefits for a patient.
[AGENT][NEUTRAL] OK, spell your first name for me.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII], and you're needing to verify benefits?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And is this for in a doctor's office?
[CUSTOMER][NEUTRAL] Uh, it's gonna be home, the place of services for DME.
[AGENT][NEUTRAL] And so what type of er so it's for equipment?
[CUSTOMER][NEUTRAL] It's a CPAP device. I'm trying to find out if it has if the patient has benefits for uh DME.
[AGENT][NEUTRAL] A CMA, so it's for a CPAP?
[CUSTOMER][NEUTRAL] Mhm, yes.
[AGENT][NEUTRAL] OK. What's the policy number?
[CUSTOMER][NEUTRAL] It is 02473361.
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] OK, and what's a good phone number, [PII], in case we're disconnected?
[CUSTOMER][NEUTRAL] Phone number is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you for that.
[AGENT][NEUTRAL] And let me verify if DME is covered under her policy, and I, I show an effective date of [PII] policy is active at this time.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Um, there is a DME benefit, uh, writer under this policy, um, which can be considered under the outpatient benefit which is up to $300.
[AGENT][NEUTRAL] That is per calendar day.
[AGENT][NEUTRAL] And information provided is verification, not a guarantee of payment. And did you have any other questions?
[CUSTOMER][NEUTRAL] So it is a cover service?
[AGENT][NEUTRAL] The CPAP machine, yeah, because it's, it's not uh disposable.
[AGENT][NEUTRAL] So up to 3, yeah, up to $300 per calendar day that's for outpatient service, not specific to DME.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] When you said outpatient is also in home could be?
[AGENT][NEUTRAL] Well, it's the device it's, it's, it's the, the, the, the equipment so the policy does have a DME rider and CPAP is a non-disposable item and so that that item can be considered under the outpatient benefit which is up to $300 per calendar day.
[CUSTOMER][NEUTRAL] The place of service?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, may I have a reference number for the call?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference, [PII] and first initial last name is [PII]. Any other questions I can help out with today?
[CUSTOMER][POSITIVE] That was it thank you very much.
[AGENT][POSITIVE] Alrighty, thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye.