AccountId: 011433970860
ContactId: 1a5d51bd-5e89-47fa-a307-50d2d9ea4066
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 382519 ms
Total Talk Time (AGENT): 159313 ms
Total Talk Time (CUSTOMER): 106800 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/1a5d51bd-5e89-47fa-a307-50d2d9ea4066_20250522T18:04_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey this is [PII] calling from provider offices.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello, I'm here. [PII] How can I assist you today?
[CUSTOMER][NEUTRAL] Yeah, I'm looking for eligibility and benefits for my patient.
[AGENT][NEUTRAL] Sure, I can assist you with that [PII]. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is 02483110.
[AGENT][NEUTRAL] I'm not sure if you heard me request the callback number, but I need a callback number just in case the call is disconnected it'll be greatly appreciated.
[CUSTOMER][NEUTRAL] OK. Sorry for that, ma'am. It's [PII].
[AGENT][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] Yeah. It's [PII].
[AGENT][NEUTRAL] OK, so give it to me again, so you said [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] So it's [PII].
[CUSTOMER][POSITIVE] Yeah, ma'am. That's right.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth that you're calling to verify eligibility for April?
[CUSTOMER][NEUTRAL] OK, ma'am. The patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility for what place of service?
[CUSTOMER][NEUTRAL] Patient's home.
[AGENT][NEUTRAL] Home health services or doable medical equipment?
[CUSTOMER][NEUTRAL] Um, durable medical equipment.
[AGENT][NEUTRAL] This policy has been active since [PII] and it's currently active.
[AGENT][NEUTRAL] The member has
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 4
[AGENT][NEUTRAL] Outpatient benefits.
[CUSTOMER][NEUTRAL] On.
[AGENT][NEUTRAL] Outpatient benefits.
[AGENT][NEUTRAL] Of $9100 per calendar year and this is not a guarantee of benefits, just a disclaimer of the policy's coverage. Doable medical equipment falls under the member's outpatient benefits. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Is it the outpatient?
[AGENT][NEUTRAL] Yes, doable medical equipment falls under the outpatient benefits.
[CUSTOMER][NEUTRAL] Patient
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Just a moment please, ma'am.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Oh, OK, ma'am. Uh.
[CUSTOMER][NEUTRAL] May I know the plan type for this patient?
[AGENT][NEUTRAL] This is a gap insurance?
[CUSTOMER][NEUTRAL] OK, ma'am.
[CUSTOMER][NEUTRAL] Is that a primary or secondary insurance?
[AGENT][NEUTRAL] This is a secondary, it's a gap insurance that assists with the primary co-pay, deductible and co-insurance for services covered under the policy.
[CUSTOMER][NEUTRAL] OK, ma'am. Could you please provide the deductible details for this patient?
[AGENT][NEUTRAL] Could you repeat your question?
[CUSTOMER][NEUTRAL] Could you please provide the deductible details for this patient?
[AGENT][NEUTRAL] You wanna know the effective date for the policy?
[CUSTOMER][NEUTRAL] Uh, no, ma'am. Deductible details like uh in network providers, deductible, and
[AGENT][NEUTRAL] There is no deductible. There is, she don't have, this is a gap insurance. We're not affiliated with her primary. This is a gap insurance that assists with her co-pay, deductible and co-insurance to her primary insurance.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK, ma'am, you, just a moment please, ma'am.
[CUSTOMER][NEUTRAL] OK ma'am, may I know the insurance for this plan?
[AGENT][NEUTRAL] There is no coinsurance attached to this policy, it's just stated, this policy is designed to assist with the deductible copay and co-insurance to her primary insurance policy, which I am not affiliated with. I don't know what her deductible per calendar year is or her out of pocket expenses. I can just provide you benefits for this policy and give you information in regards to this policy only.
[AGENT][NEUTRAL] Which I did, would you like for me to repeat the benefits again for you?
[CUSTOMER][NEUTRAL] Uh, no, ma'am. If the Medicare is the primary insurance for this member.
[AGENT][NEUTRAL] I'm not sure. I don't, I'm not sure who's the primary insurance company.
[AGENT][NEUTRAL] You would have to reach out to the pro the insurer to verify that information. Is there anything else that I can assist you with, [PII]?
[CUSTOMER][NEUTRAL] Uh, yes, ma'am. Uh, is this covered the primary deductible and uh co-insurance?
[CUSTOMER][NEUTRAL] This plan
[AGENT][POSITIVE] Yes, that is correct. This is what I just expressed to you.
[CUSTOMER][NEUTRAL] OK, ma'am. Thank you for that. Could you please provide the call reference number and your name for this call?
[AGENT][NEUTRAL] Thanks for calling APL and we don't provide reference numbers, but you can use my name and today's date as a reference. It's [PII]. Today's date is a reference. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] That's it for today's call, ma'am.
[AGENT][POSITIVE] Thanks for calling APL. Have a great day. Goodbye.