AccountId: 011433970860
ContactId: da6ed967-903e-464a-9d27-aa0396f8ae3b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 352529 ms
Total Talk Time (AGENT): 112636 ms
Total Talk Time (CUSTOMER): 88582 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/da6ed967-903e-464a-9d27-aa0396f8ae3b_20250331T13:26_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, uh, this is [PII], and I'm calling from Edge Park Medical Suppies on a recorded line, and I'm calling to verify benefits and eligibility for GMA.
[AGENT][POSITIVE] OK, sure, I can assist you with eligibility and benefits.
[AGENT][NEUTRAL] And may I have your name one more time or can you spell it out for me so I can notate it.
[CUSTOMER][NEUTRAL] Mhm sure um it is [PII]
[AGENT][NEUTRAL] OK, thank you. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure it is [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Um, yeah, sure, I do have here 2608319.
[AGENT][NEUTRAL] That's 2608319.
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] This is for [PII] and the date of birth is on [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, let me check and see if we cover DME for this member, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] I'm waiting on the system. I'm so sorry.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. And this is not a guarantee of payment, just a verification of coverage, and this is just a disclaimer. Um, and it looks like we do cover DME that is subject to the outpatient maximum which is 750 per day. Um, now, we do not cover disposable supplies, OK? So that's just gonna be for regular DME, no disposable supplies are covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, by the way, do you need the CPT code?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Do you need a CPT code for GME um
[AGENT][NEUTRAL] We don't need the CBT code. If it's disposable, it's just not gonna pay. If it's not disposable, it's part of the benefit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, but, uh, just give me a moment here. I just wanted to confirm, is this a supplemental plan?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This, yes, this is a secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] Oh, OK, I see is there any supplemental letter?
[AGENT][NEUTRAL] No, because it's not a Medicare or Medicaid supplemental. This is a uh secondary supplemental to the major medical, to any major medical.
[CUSTOMER][POSITIVE] OK, thank you so much give me a moment here.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh just wanted to confirm uh is there any group number for this plan?
[AGENT][POSITIVE] Yes, let me get that for you.
[CUSTOMER][POSITIVE] Mhm and also a effective date.
[AGENT][NEUTRAL] Um, yes, one moment please.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] The effective date of the policy is [PII]. It is active at the moment.
[AGENT][NEUTRAL] And um what other information you said you needed?
[CUSTOMER][NEUTRAL] Uh, the group number.
[AGENT][NEUTRAL] OK, the group number is.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] 80,020.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Alright, so yeah, I think I've got all the information that I needed for this patient. Thank you so much. Sorry, uh, your name again is?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][POSITIVE] Alright thank you so much and one last thing, can I have a reference number for this call please?
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, alright, thank you so much so for assisting me today, and you do have a great day ahead. Thank you.
[AGENT][POSITIVE] You're welcome. You as well. Thank you for calling APR. Bye bye.
[CUSTOMER][NEUTRAL] Alright bye.