AccountId: 011433970860
ContactId: 8b362ff7-7961-43c5-9c20-2444e0361b71
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 171899 ms
Total Talk Time (AGENT): 78078 ms
Total Talk Time (CUSTOMER): 55625 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/8b362ff7-7961-43c5-9c20-2444e0361b71_20250414T21:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Thank you for calling ATL.
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Bioenni, the DME provider. I'm calling to get eligibility and benefits for a patient.
[AGENT][POSITIVE] Yeah, I could check eligibility and benefits for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Policy number.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Would that be the benefit cert number?
[AGENT][NEUTRAL] Uh, yes.
[CUSTOMER][NEUTRAL] OK, it's 02510692.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] OK and uh what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after major medical pays, and we were needing to look at the outpatient benefits, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, of course I will let you know verification of coverage is not a guarantee of payment for claims, so their outpatient benefit is on a per calendar day basis. It pays up to $750 per calendar day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so is DME included in that?
[AGENT][NEUTRAL] Yes, DME is as a covered benefit.
[CUSTOMER][NEUTRAL] OK, and so that, um, just, uh, after the primary they you all will pay up to $750.
[AGENT][NEUTRAL] Per day, yes, uh, towards copay, deductible or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and is there any prior author required?
[AGENT][NEUTRAL] No, as this policy is very dependent on uh the primary as long as they're willing to pay this policy can.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK, alright, thank you and um is there a reference number for the call?
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date. Uh so my name is spelled [PII] Was there anything else I could help you with [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, that's all thank you so much.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thanks bye bye.
[CUSTOMER][NEUTRAL] Bye.