AccountId: 011433970860
ContactId: a39e0022-2960-4567-bcab-f99a9af1fc67
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210440 ms
Total Talk Time (AGENT): 101856 ms
Total Talk Time (CUSTOMER): 57948 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/a39e0022-2960-4567-bcab-f99a9af1fc67_20250604T19:43_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Sleep Management doing business as FineMed. I was calling to get network status and benefits and eligibility for a member for DME.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with benefits. Um, first, could I get your name again and a good callback number?
[CUSTOMER][NEUTRAL] [PII] last initial [PII] [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] 02449773
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK. Thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active. And you said this was for DME?
[CUSTOMER][NEUTRAL] Yes, and it's secondary.
[AGENT][NEUTRAL] OK. Yes, ma'am. This policy is for secondary gap insurance and for DME services, we cover up to 2000 per calendar year and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEGATIVE] What is the co-insurance? I pretty much I'll pick up with the primary doesn't pay.
[AGENT][NEUTRAL] Yes, yeah.
[CUSTOMER][NEUTRAL] Up to [PII] you said?
[AGENT][NEUTRAL] Right. The charges that go to the co-pay, the co-insurance, and the deductibles.
[AGENT][NEUTRAL] Only those charges will pick up. If anything is denied, um, we don't cover that.
[AGENT][NEUTRAL] If it's denied by the primary insurance.
[CUSTOMER][NEUTRAL] And do y'all have an in and out of network status?
[AGENT][NEUTRAL] Um, no, ma'am. We work with our providers. Again, we go by the primary carrier's guidelines.
[CUSTOMER][NEUTRAL] OK. And what is the payer ID for claims?
[AGENT][NEUTRAL] The pair ID is 60801.
[CUSTOMER][NEUTRAL] And do you have the address?
[AGENT][NEUTRAL] Um, yes, ma'am. The address is [PII].
[AGENT][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And zip zip code is [PII].
[CUSTOMER][NEUTRAL] OK, what is your first name and last initial?
[AGENT][NEUTRAL] Um, my name is [PII]. Um it's spelled [PII]. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] A reference number.
[AGENT][NEUTRAL] You can use my name and today's date for the reference number.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. You have a great day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][NEUTRAL] Do
[CUSTOMER][NEUTRAL] OK