AccountId: 011433970860
ContactId: d8c2336f-e409-40af-bb0f-df844f3a37f7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 277290 ms
Total Talk Time (AGENT): 106892 ms
Total Talk Time (CUSTOMER): 117375 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/d8c2336f-e409-40af-bb0f-df844f3a37f7_20250219T19:16_UTC.wav
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[CUSTOMER][NEUTRAL] it.
[AGENT][NEUTRAL] One A. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] You know that.
[CUSTOMER][NEUTRAL] Yes, hello. Yeah, um, my name is [PII]. I'm calling from Lane Care. I need to verify benefits please for DME.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what is um and you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] OK, and Miss [PII], can you give me the name of the provider again you're calling for?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what is your callback number please just in case our call is disconnected.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and what is the patient's name, date of birth, and?
[CUSTOMER][NEUTRAL] Uh, patient name is [PII]
[CUSTOMER][NEUTRAL] URTS. Date of birth is [PII].
[AGENT][NEUTRAL] OK, and the policy number, please?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Policy number 951-731-905.
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Do you see another number?
[CUSTOMER][NEUTRAL] I see a plan number.
[CUSTOMER][NEUTRAL] 00 no no no no no no.
[CUSTOMER][NEUTRAL] I'm giving you something totally another card that I was reading policy, hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well, uh, you want the outpatient?
[AGENT][NEUTRAL] Either one is fine.
[CUSTOMER][NEUTRAL] Benefit certification number, OK. 016.
[CUSTOMER][NEUTRAL] 118
[CUSTOMER][NEUTRAL] 32 ML 8.
[AGENT][NEUTRAL] OK, let me look that policy up and you're just wanting eligibility, is that correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], yes, uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I do show that [PII] does have an active policy and his effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, do you guys cover?
[CUSTOMER][NEUTRAL] 20% of the pay.
[CUSTOMER][NEUTRAL] The primary
[AGENT][NEUTRAL] No, uh, no, and this is just to verify his benefits. It's not a guarantee of payment. We're a secondary insurance, a gap insurance that helps with deductible, co-pay, and co-insurance.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] He has an inpatient benefit amount per calendar year of $2500 and an outpatient calendar year benefit amount of $1500 to go towards deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 1, 1500.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Per year.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh right, oh yeah, does he me anything? Has he met anything yet or?
[AGENT][NEUTRAL] Let me look real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEGATIVE] No, nothing has been used for the year of [PII].
[CUSTOMER][POSITIVE] About 25. OK, good.
[CUSTOMER][NEUTRAL] OK, what's the billing address?
[AGENT][NEUTRAL] Uh, the claim's mailing address is [PII]. That's in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that zip code is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK and your name again, please?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][POSITIVE] Sorry. OK, thank you very much.
[AGENT][POSITIVE] You're welcome, [PII]. I hope you have a great day and
[CUSTOMER][NEUTRAL] Uh, you have a reference number?
[CUSTOMER][NEUTRAL] Uh, I have one more thing to ask. You have a reference number for the call?
[AGENT][NEUTRAL] Yes, you can use my name and today's date.
[CUSTOMER][NEUTRAL] 2 days, OK.
[CUSTOMER][POSITIVE] Thank you very much.
[AGENT][POSITIVE] You're welcome have a good day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] 5