AccountId: 011433970860
ContactId: 3ba39f91-09c3-4c83-b356-ebf7de13f7ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 276679 ms
Total Talk Time (AGENT): 111204 ms
Total Talk Time (CUSTOMER): 89890 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/3ba39f91-09c3-4c83-b356-ebf7de13f7ab_20250613T19:17_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for, I'm sorry, good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm calling for Hosner home medical equipment to verify the member's benefits and prior authorization. Would you help with that?
[AGENT][NEUTRAL] OK, sure. I can verify benefits for you. And your name is again?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Uh spell your name, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the policy number, please?
[CUSTOMER][NEUTRAL] Policy number is 1265678.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] Patient's name is, it is, it's [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And what was the callback number in case the call drops?
[CUSTOMER][NEUTRAL] Callback number is [PII], and it is a direct line, no extension.
[AGENT][NEUTRAL] OK, I'm showing his effective date is [PII]. Policy is active. And what benefits are you needing for this patient?
[CUSTOMER][NEUTRAL] It's for DME.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, um, not a guarantee of payment, just a verification of coverage, and you said for outpatient, correct?
[CUSTOMER][NEUTRAL] Right, yeah, business home.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, with this policy is secondary, we help with major medicals, deductible, co-pay, and or co-insurance, and the patient has a benefit max up to $4750 per calendar year.
[AGENT][NEUTRAL] And they do have a $250 deductible that is applied to everything but preventative.
[AGENT][NEUTRAL] I mean, I'm sorry, they do have a $250 deductible for outpatient. I apologize. Yes.
[CUSTOMER][NEUTRAL] It's $250 deductible, right?
[CUSTOMER][NEUTRAL] OK. And is, uh, may I know the amount for the deductible?
[CUSTOMER][NEUTRAL] I mean a commission.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I show the patient has met their deductible for the year and they have a balance remaining of, give me one moment.
[AGENT][NEUTRAL] $4,612.23 remaining.
[CUSTOMER][NEUTRAL] You said it's $250 for, right?
[AGENT][NEUTRAL] Yes, they've met their deductible.
[CUSTOMER][NEUTRAL] OK, it's currently 0, right?
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEGATIVE] Currently it's a 0 right for the reable.
[AGENT][NEUTRAL] They've met their deductible, so they've already met that $250 deductible for the year.
[CUSTOMER][NEUTRAL] OK, is there an out packet?
[AGENT][NEUTRAL] Excuse me?
[CUSTOMER][NEUTRAL] Is there any out of pocket amount for initial?
[AGENT][NEUTRAL] They have a balance remaining of $4,612.23.
[CUSTOMER][NEUTRAL] OK, thank you. And uh may I know the co-insurance?
[AGENT][NEUTRAL] There is no coinsurance.
[CUSTOMER][POSITIVE] 100% covered, right?
[AGENT][NEUTRAL] OK, is there anything else I can assist you with today [PII]?
[CUSTOMER][NEUTRAL] Uh, yes, would you please repeat the ID for the number?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, thank you so much for this one.
[CUSTOMER][NEUTRAL] And yeah, may I know your name again?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] Thank you, [PII]. Yeah, [PII] for this call.
[AGENT][NEUTRAL] You may use my name in today's date.
[CUSTOMER][POSITIVE] OK, [PII], thank you and a wonderful day. You just you happy. Bye-bye.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Mhm thank you for calling APL bye.
[CUSTOMER][POSITIVE] I hope you can