AccountId: 011433970860
ContactId: 4c8583fb-0c91-4ac7-a34d-81a0f96412de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 165809 ms
Total Talk Time (AGENT): 82508 ms
Total Talk Time (CUSTOMER): 97410 ms
Interruptions: 6
Overall Sentiment: AGENT=1.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/4c8583fb-0c91-4ac7-a34d-81a0f96412de_20250218T19:14_UTC.wav
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[CUSTOMER][NEUTRAL] the
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am. Hi, my name is [PII]. I'm calling from medical equipment distributors trying to verify um benefits for a patient, please.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the benefits, and [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yep, [PII].
[CUSTOMER][NEUTRAL] And then the patient's policy number is 02440112. Mhm.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Um, patients, yeah, patient's name is [PII].
[CUSTOMER][NEUTRAL] Um, her date of birth, I'm sorry, let me get you back to her [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing that the policy is active, it's been effective since [PII]. And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Yes, that's what that's what we've been doing, um, because we are already um schedule um.
[CUSTOMER][NEUTRAL] Um, durable medical equipment.
[AGENT][NEUTRAL] OK, so DME comes out of the um outpatient benefit, which is $2500 per calendar year. Did you want me to see if any of that balance has been used?
[CUSTOMER][NEUTRAL] And if you need to, if you need to cancel.
[CUSTOMER][NEUTRAL] Um, yes, and also does it cover the primary deductible?
[AGENT][NEUTRAL] Yes, our policy pays towards the copay, deductible and co-insurance of coverage charges after primary.
[CUSTOMER][NEUTRAL] Yeah, because I think you said it covers after primary, so it does not cover the primary deductible.
[AGENT][NEUTRAL] So we're secondary. So primary applies it and we pay towards it. So primary will apply whatever their co-pay is or deductible, the patient pays it and then we can reimburse the payment or the patient, or we can pay towards the deductible or co-pay, depends on if you bill or it has to be done to be seen.
[CUSTOMER][NEUTRAL] It's like very limited so you probably won't be able to get it until the first.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh yes, there's only one spot and I.
[AGENT][NEUTRAL] And they have not used any of the benefits for [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Complete this call um because they need to be set up so that's about 90 may not um but I'm just
[AGENT][NEUTRAL] Alrighty, [PII], was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] OK. No, that's all. Can I have a call reference please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. That's [PII], first initial and my last name is [PII].
[CUSTOMER][POSITIVE] Alright, thank you much.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye.