AccountId: 011433970860
ContactId: a9735e9e-cb5b-4d15-8299-193d276703b0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 272720 ms
Total Talk Time (AGENT): 100632 ms
Total Talk Time (CUSTOMER): 114470 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/a9735e9e-cb5b-4d15-8299-193d276703b0_20250110T17:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey [PII]. I just had a quick question. Um, I know that it mentions in my
[CUSTOMER][NEUTRAL] I have an account with APL and I know he mentions durable medical equipment as one of the reimbursements that we're able to get, which I believe that would include my CPAP machine.
[CUSTOMER][NEUTRAL] So, the, the, the question I really had is, how would I go about getting reimbursed, cause I, I got billed by the, the company, cause I guess my insurance company, my insurance is not covering.
[CUSTOMER][NEUTRAL] Until I reached the deductible and they've billed me. So, would I just make the payment to them and then
[CUSTOMER][NEUTRAL] File a claim with you guys afterwards?
[AGENT][NEUTRAL] OK, so we have different policies. I will have to pull your policy up to see which policy you have with us.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] May I have that policy number?
[CUSTOMER][NEUTRAL] Um, I think I have the
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] It will be the outpatient benefit certification number.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] But I'm looking at my card right now.
[CUSTOMER][NEUTRAL] OK, I got the policy. It's uh 024.
[CUSTOMER][NEUTRAL] 73311.
[AGENT][NEUTRAL] And may I have your name and date of birth please?
[CUSTOMER][NEUTRAL] [PII], [PII]
[AGENT][NEUTRAL] And Mr. [PII], I do need to verify your mailing address and email address listed on file.
[CUSTOMER][NEUTRAL] Uh, the mailing is [PII].
[CUSTOMER][NEUTRAL] Uh, the email address, uh, let's try, uh [PII].
[AGENT][NEUTRAL] Mhm, that is correct and may I have a callback number just in case this call is disconnected?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][POSITIVE] And thank you so much Mr. [PII] for verifying your policy. I'm pulling that information up for you now.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so with this policy you do have the midlink supplemental plan you would have to submit in the primary insurance EOB that shows that that amount was applied to your deductible, co-insurance, or co-pay, and you would also have to have that diagnosis code for that date of service or for that DME equipment.
[CUSTOMER][NEUTRAL] Would that be on the EOB, the, the diagnostic code?
[AGENT][NEUTRAL] Normally it's not listed, you would have to contact either the provider that submitted that in for you to use, or you will contact the DME.
[AGENT][NEUTRAL] Facility to get that diagnosis code.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now if you would like for them to submit it in, you do have the option to give that provider this information and they can submit in the needed documentation as well.
[CUSTOMER][POSITIVE] OK, so I would just, so I wouldn't even have to pay them, you guys would pay them directly.
[AGENT][NEUTRAL] Yes, if they submit in that information and we we receive it, once we receive it, the examiner will review it and they will process it based off of the information that was received.
[CUSTOMER][NEUTRAL] OK. Um, I just have one final question. Is there a wellness?
[CUSTOMER][NEUTRAL] Clause clause on this where if I get like an annual uh physical, I can get some kind of uh
[CUSTOMER][NEUTRAL] Money, I guess.
[AGENT][NEUTRAL] So for this policy, it is for sickness and injury only. It does not cover any type of preventative or wellness.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] OK, thank you very much for all your assistance.
[AGENT][POSITIVE] You're welcome, thank you for calling American Public Life have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye.