AccountId: 011433970860
ContactId: 15202d0e-8e90-4d11-b0a9-bfe961cb5ed4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 169690 ms
Total Talk Time (AGENT): 81788 ms
Total Talk Time (CUSTOMER): 66673 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/15202d0e-8e90-4d11-b0a9-bfe961cb5ed4_20250128T13:54_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm with Hanger Prosthetics and Orthotics trying to see, get benefits on a patient and see if DME is covered under their policy.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you with that DMA benefit. [PII], what is a good callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you, [PII] and what is the policy number for the patient?
[CUSTOMER][NEUTRAL] It is 02292679.
[AGENT][NEUTRAL] And the patient's name and date of birth, please, ma'am.
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][NEUTRAL] All right, thank you. And I can help you with those benefits for [PII]. I am showing his policy is active. Effective date is [PII], and this is a secondary policy to the to the policyholder's Major Medical.
[AGENT][NEUTRAL] He does have covered uh benefits for DME.
[AGENT][NEUTRAL] That is under his outpatient benefit of $500 per calendar day.
[AGENT][NEUTRAL] Now that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] So you allow $500 only.
[AGENT][NEUTRAL] That's correct, and that's per day.
[CUSTOMER][NEUTRAL] OK and.
[CUSTOMER][NEUTRAL] Has any of that been uh.
[CUSTOMER][NEUTRAL] Used, I guess it wouldn't be since it's per day yeah I got you.
[AGENT][NEUTRAL] Well, it's a per calendar day. That's right.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Alright, so $500 at 100% and that's it, alright.
[CUSTOMER][NEUTRAL] Got it and is authorization required [PII]?
[AGENT][NEUTRAL] Authorization is not required. We do follow the guidelines of the major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So if the primary plan covers it, you would, if they don't cover it you don't.
[AGENT][NEUTRAL] As long as it meets the definition of DME.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] According to the guidelines of our policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][NEUTRAL] And could I get a call reference number?
[AGENT][NEUTRAL] Call reference number is my name and today's date, and I spell my name [PII].
[AGENT][POSITIVE] [PII], it was such a pleasure to assist you with those benefits. Anything else I can help you with today?
[CUSTOMER][POSITIVE] Not at all, thank you so much have a great day.
[AGENT][POSITIVE] Hope you have a wonderful day as well, [PII]. Thank you for calling APL. Take care.
[CUSTOMER][NEUTRAL] Uh huh bye bye now.
[AGENT][NEUTRAL] Bye bye.