AccountId: 011433970860
ContactId: 9119024b-3c05-4724-9552-a0d9a58d3787
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167059 ms
Total Talk Time (AGENT): 72976 ms
Total Talk Time (CUSTOMER): 53965 ms
Interruptions: 2
Overall Sentiment: AGENT=1.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/9119024b-3c05-4724-9552-a0d9a58d3787_20250506T17:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I work for a DME company and I'm calling to check eligibility on a mutual patient.
[AGENT][NEUTRAL] Sure, I can check eligibility for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02145975.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] Um, the members, uh, [PII].
[AGENT][NEUTRAL] OK. Do you have that date of birth? Sure.
[CUSTOMER][NEUTRAL] And let me get her date of birth again, yes.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that [PII]. So this policy is active. Effective date was [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And does the patient have deductible or is it covering at 80% for DME?
[AGENT][NEUTRAL] Not
[AGENT][NEUTRAL] OK, so this policy, this is a limited indemnity medical plan, um, so it is different than traditional major medical in the sense that of course it is limited as to what is and is not covered. Um, it pays a set dollar amount per covered office visit or procedure. There's no co-pays, no deductibles, nothing like no authorization required. Let me check, uh, to see if DME is in fact a covered benefit. Give me just a moment.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so DME is not going to be a covered benefit under this policy, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That is what I needed to know.
[AGENT][NEUTRAL] Alright, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] OK, I will let the patient know that she would have to patient pay if she wants the machine. OK, thank you. Yeah, no that's everything.
[AGENT][POSITIVE] Sure, right, yeah, alright, thanks for calling APL have a great rest of your day. It's OK, it's [PII]
[CUSTOMER][NEUTRAL] And I'm sorry, your name again?
[CUSTOMER][POSITIVE] OK alrighty thank you.
[AGENT][POSITIVE] Of course, thanks for calling APL have a great rest of your day.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] You too.