AccountId: 011433970860
ContactId: 8863bb6c-4374-44f3-9d78-4c6a6d0f6341
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 271649 ms
Total Talk Time (AGENT): 144257 ms
Total Talk Time (CUSTOMER): 76928 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/8863bb6c-4374-44f3-9d78-4c6a6d0f6341_20250326T19:50_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office, and I want to check the benefits of patient. Could you please help me with?
[AGENT][NEUTRAL] I I sure can, but I am so sorry I did not catch your name.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, [PII], thank you for that information. Now your patient's name, I mean, your patient's policy number.
[CUSTOMER][NEUTRAL] Uh yes, the patient's policy number is 02120428.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Alrighty, [PII], thank you for that. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] Uh, yes, one moment, please.
[CUSTOMER][NEUTRAL] The callback number is
[CUSTOMER][NEUTRAL] [PII] and the extension is [PII].
[AGENT][NEUTRAL] Alrighty, [PII], thank you for that information. Now, your patient's name and date of birth, please, ma'am.
[CUSTOMER][POSITIVE] thank you.
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Alrighty, thank you for that information, [PII]. Let's see, looks like.
[AGENT][NEUTRAL] Maybe they flipped to a different policy number. Give me just a moment, let me do some checking. Let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yep, he did flip to a different policy number, so let me give you that correct policy number, uh, [PII], you ready?
[CUSTOMER][POSITIVE] Yes, I'm ready.
[AGENT][NEUTRAL] 02.
[AGENT][NEUTRAL] 56.
[AGENT][NEUTRAL] 65.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] To fab.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Yes, ma'am. I do show this medical supplemental, uh, effective date on this policy went into effect [PII]. Patient is current and active, but I must advise that verification of coverage is not a guarantee of payment on a claim, but you did say you won benefits on Donald. Is that correct?
[CUSTOMER][NEUTRAL] know
[CUSTOMER][NEUTRAL] Mhm. Yes.
[AGENT][NEUTRAL] OK. What type of benefits you needing today, [PII]?
[CUSTOMER][NEUTRAL] Uh sorry, what?
[AGENT][NEUTRAL] Yeah, what exact benefit are you needing?
[CUSTOMER][NEUTRAL] You said the effective date is December, uh it is for the DME CPAP supplies. You said the effective date is [PII], right?
[AGENT][NEUTRAL] The [PII]. That is correct.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm. OK, so you won't DM me benefits. So let me get over there. Let's see.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well looks like what we are, of course, is the medical supplemental plan. So the only thing that we will pick up and pay on is anything that is applied towards the patient's deductible, co-pay, or co-insurance at their primary insurance carrier for sickness and injury only. Nothing routine here is covered no matter what.
[CUSTOMER][NEUTRAL] so
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] For the DME benefit, they have no pre-cert, no deductible, and a $3000 benefit payable per calendar year.
[CUSTOMER][NEUTRAL] Thank you. And also, could you please tell me that what type of plan is this like is this?
[AGENT][NEUTRAL] This is a medical supplemental plan.
[CUSTOMER][NEUTRAL] Thank you. Could you please spell out your name for me, please?
[AGENT][NEUTRAL] I sure can, [PII]. My name is [PII] spelled [PII]
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Is that all I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] And your last
[CUSTOMER][NEUTRAL] And last name initial?
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Is there any reference number for this call?
[AGENT][NEUTRAL] No, ma'am, we don't give reference numbers, but you can use my name in today's date if you need to do so, [PII], OK?
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][POSITIVE] Yes, ma'am, and thanks for calling APL [PII]. Bye-bye.