AccountId: 011433970860
ContactId: 878f5b84-f0d0-43a6-9f85-78ef26b83174
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 436320 ms
Total Talk Time (AGENT): 126555 ms
Total Talk Time (CUSTOMER): 86449 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/878f5b84-f0d0-43a6-9f85-78ef26b83174_20250506T17:10_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] in customer service. How are you?
[AGENT][POSITIVE] Hey [PII], I'm good how are you?
[CUSTOMER][NEUTRAL] I am good. Um, I have an insured on the line calling to check claim status.
[AGENT][NEUTRAL] OK. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, I do. Let me see. It is 258.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 49
[CUSTOMER][NEUTRAL] 80.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] He has been fully verified and the phone number, his callback number is the same that's in the system and it's for [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And who am I speaking with?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] [PII], OK. All right, I'm ready.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][POSITIVE] All right, here it comes, thank you.
[AGENT][POSITIVE] All right. You're, you're welcome.
[AGENT][NEUTRAL] Hi [PII], this is [PII]. Um, it's my understanding that you're checking on a claim status.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and I have the policy number of 2,584,980.
[CUSTOMER][NEUTRAL] Let me see, yes, 02584980.
[AGENT][NEUTRAL] OK, give me one moment to pull up that information.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] And is your name [PII] or [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] yeah, OK.
[AGENT][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] And what is the data service of the claim?
[CUSTOMER][NEUTRAL] Um, I believe it was yesterday.
[AGENT][NEUTRAL] OK, so are you checking claims? Are you checking claim status or you're trying to get benefits?
[CUSTOMER][NEUTRAL] The uh the 5th.
[CUSTOMER][NEUTRAL] A claim status for um a prescription.
[CUSTOMER][NEUTRAL] From uh Supercare.
[CUSTOMER][NEUTRAL] CPAP machine?
[CUSTOMER][NEUTRAL] I'm not sure if so.
[CUSTOMER][NEUTRAL] Wanted to see what the status was.
[AGENT][NEUTRAL] OK, now we've not received a claim.
[CUSTOMER][NEUTRAL] You're not? OK, no worries, man. I was just checking.
[AGENT][NEUTRAL] Yeah, you said it's for durable medical equipment, a CPAP machine?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And super care.
[AGENT][NEUTRAL] And that's a, is that a, a pharmacy or?
[AGENT][NEUTRAL] Or
[CUSTOMER][NEUTRAL] It's a medical supply. Um,
[AGENT][NEUTRAL] OK, do you mean, OK, got you.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me verify.
[AGENT][NEUTRAL] If durable medical equipment is covered under your policy.
[AGENT][NEUTRAL] So you're you're speaking of the equipment itself, right?
[AGENT][NEUTRAL] Because I think I heard you use the word prescription.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So you purchased or you're renting a CPAP machine?
[CUSTOMER][NEUTRAL] Uh, my, my sleep doctor is prescribing me one, yes.
[AGENT][NEUTRAL] OK, let me look at your policy and, and see if DME, which is the CPAP machine, is a form of durable medical equipment to see if the, that's covered under the policy that you have with us.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] There's a benefit for the sleep study, but the CPAP machine itself is not a covered item under your policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so they may submit the claim, um, and we'll, you know, go ahead and acknowledge it and then send them out an explanation of benefits of how the claim was processed and whether it was covered or not, but it's not covered under this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] All right. Any other
[CUSTOMER][NEUTRAL] Should I be uh reach out to Supercare to, or should I wait for the claim to to finish on.
[AGENT][NEUTRAL] You know, you know, you can reach out to them if they wanna contact us and just go over your benefits. We can um explain it to them as well, um, and you would just give them the policy number that you provided to us and um we can go we can go over their policy be your policy benefits with them.
[CUSTOMER][NEUTRAL] On their end
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other questions, Mr. [PII]?
[CUSTOMER][POSITIVE] Got it, thank you.
[CUSTOMER][POSITIVE] That should be it. Thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too. Goodbye.
[AGENT][NEUTRAL] Bye bye.