AccountId: 011433970860
ContactId: 0e3213c7-1bf3-432b-9487-741ce6109d5c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 574950 ms
Total Talk Time (AGENT): 140712 ms
Total Talk Time (CUSTOMER): 155893 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/0e3213c7-1bf3-432b-9487-741ce6109d5c_20250516T13:28_UTC.wav
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[AGENT][NEUTRAL] Morning, thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] from American Home Care Equipments. I'm calling.
[CUSTOMER][NEUTRAL] To check eligibility and benefits of a member.
[AGENT][NEUTRAL] OK, do you have a phone number and get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] That would be [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Sure, um, that would be.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] That's our payer ID number.
[CUSTOMER][NEUTRAL] OK, that's what they provided me.
[AGENT][NEUTRAL] Do you have a copy of the card?
[CUSTOMER][NEUTRAL] Uh, no, I only have your patient information, the group number.
[AGENT][NEUTRAL] Do you have their social security number?
[CUSTOMER][NEUTRAL] The group number is.
[CUSTOMER][NEUTRAL] No, just the, just the, the just the number that I provided you the group number.
[AGENT][NEUTRAL] Well, I can't look it up by that. Do you know whose name the policy is in?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Patient
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, spelling the first name and last name please.
[CUSTOMER][NEUTRAL] Sure. Um first name is [PII], that's [PII]
[CUSTOMER][NEUTRAL] Last name is [PII].
[CUSTOMER][NEUTRAL] And then another word, [PII].
[CUSTOMER][NEUTRAL] Another word
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, hold on just a moment. I'll see if I can find it by the name.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And what's his date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, [PII]. And you were needing benefits?
[CUSTOMER][POSITIVE] You're welcome
[CUSTOMER][NEUTRAL] Yes, for DME.
[AGENT][NEUTRAL] OK, I can help you with that. His policy number?
[AGENT][NEUTRAL] Is 02.
[AGENT][NEUTRAL] 361-159.
[AGENT][NEUTRAL] The effective date is [PII].
[AGENT][NEUTRAL] Any benefits given over the phone is not a guarantee of payment.
[AGENT][NEUTRAL] This policy coordinates with the primary insurance?
[AGENT][NEUTRAL] Whatever the primary applies to their deductible, copay, or co-insurance only.
[AGENT][NEUTRAL] We'll pay up to $1000 per calendar day.
[AGENT][NEUTRAL] And he has not used anything?
[AGENT][NEUTRAL] But it is per calendar day so.
[CUSTOMER][NEUTRAL] Um, does that also cover deductible, you said?
[AGENT][NEUTRAL] I said deductible, co-pay, or co-insurance.
[CUSTOMER][NEUTRAL] co-pay or coinsurance.
[CUSTOMER][NEUTRAL] So, if the primary has a deductible, that will be covered. Um,
[CUSTOMER][NEUTRAL] Like for example, patients has United Healthcare, it has 500 deductible.
[CUSTOMER][NEUTRAL] So that will be automatically 0, is that right?
[AGENT][POSITIVE] Right, we would pay up to the 1000, yes, that's right.
[CUSTOMER][POSITIVE] Got it thank you so much and I have another patient also.
[AGENT][NEUTRAL] OK, hold on just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, do they, do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, I think I have it. Um, it's 02475 I'm sorry, let me repeat that. Um 02475387.
[AGENT][NEUTRAL] And the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the date of birth.
[CUSTOMER][NEUTRAL] Date of birth, [PII].
[AGENT][NEUTRAL] And you were needing benefits for DME as well?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, any benefits given over the phone is not a guarantee of payment?
[AGENT][NEUTRAL] The effective date is [PII].
[AGENT][NEUTRAL] Hold on one moment, let me look up those benefits, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] On this one we'll pay up to $6000.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Let me check and see if it's per calendar year or.
[AGENT][NEUTRAL] For calendar day hold on one moment.
[AGENT][NEUTRAL] It is per calendar year on this one.
[CUSTOMER][NEUTRAL] For calendar year.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEGATIVE] And it's not yet fully satisfied.
[AGENT][NEUTRAL] Let me see if they've used anything hold on one moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] It is used $156.67.
[CUSTOMER][POSITIVE] Got it, thank you so much. And uh that also coordinates with the primary insurance.
[AGENT][POSITIVE] Yes ma'am, exactly like the other one.
[CUSTOMER][NEUTRAL] Uh, covers deductible, co-pay, and the co-insurance.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Got it, thank you so much. Is there, can I have a call reference number for call today?
[AGENT][NEUTRAL] We do not have call reference numbers you use my name in today's date.
[CUSTOMER][NEUTRAL] Can I have your.
[CUSTOMER][NEUTRAL] Can I have your full name please? um so your name.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] is the last initial.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] OK, got it, thank you so much, [PII]. You have a good one.
[AGENT][POSITIVE] Thank you for calling APL, [PII]. You have a good day.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] Happy weekend.
[AGENT][NEUTRAL] You too. Mhm. Bye-bye.
[CUSTOMER][NEUTRAL] Bye now.