AccountId: 011433970860
ContactId: ebfd5412-4c91-4d94-8a30-537604ceda03
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 536909 ms
Total Talk Time (AGENT): 141494 ms
Total Talk Time (CUSTOMER): 202729 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/ebfd5412-4c91-4d94-8a30-537604ceda03_20250603T14:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, this is [PII] of the Legacy Oxygen in [PII], and I'm calling about a patient, um, on his insurance to see if it's active and, um, get his uh benefit information.
[AGENT][POSITIVE] I can help you with eligibility and benefits. Can I get your name and where you're calling from one more time? I'm sorry.
[CUSTOMER][NEUTRAL] So my first name is [PII]
[CUSTOMER][NEUTRAL] Last uh initial last name is [PII]
[CUSTOMER][NEUTRAL] And I'm calling from Legacy Oxygen in [PII].
[AGENT][NEUTRAL] And can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Mhm [PII].
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Hang on, that's time let me look it off of here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So do I give you the ones so if I'm looking at the card, um, on the right hand side it says benefits in a card and on the left hand side at the top it says um focus. So should I give you, do I give you that number underneath the the one that says focus where it says employee ID?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Is there anything that says policy certificate number?
[AGENT][NEUTRAL] Or inpatient or outpatient benefit number?
[CUSTOMER][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] No, I mean on his cards like if I'm looking at the card I put the top left corner it says member and it says focus work enforcement uh workforce management and then to the right hand side it says medical um multi plan and then uh to the bottom left is the pharmacy and then on the back side it has, it says 90 degree benefits.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But I don't see anything that has any type of number like that.
[CUSTOMER][NEUTRAL] Um, and I'm multi-plan, um, side that says medical, it just says MEC coverage, no copayments, no deductible, no out of pocket, um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, do you have his social security number?
[CUSTOMER][NEUTRAL] We were seeing one like this.
[CUSTOMER][NEUTRAL] Um let me see.
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's his name?
[CUSTOMER][NEUTRAL] [PII], last name [PII]
[AGENT][NEUTRAL] OK, give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Can you verify his date of birth for me please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you so much.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And it looks like he has several policies with us.
[AGENT][NEUTRAL] Um, I just pulled up his hospital indemnity plan.
[CUSTOMER][POSITIVE] So I'm a durable.
[CUSTOMER][NEUTRAL] OK, so I'm a durable medical equipment company or I work here for a durable medical equipment company, so I'm needing to find out if, if he has Part B insurance that would cover durable medical equipment and if so, when all that became, you know, effective and if he has any, um, deductible co-pay, you know, things like that.
[AGENT][NEUTRAL] OK, let me check.
[AGENT][NEUTRAL] Give me just a moment while I check. He's got 4 policies with us, so give me just a second.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Oh goodness.
[CUSTOMER][NEGATIVE] Well this is the most confusing card I've ever seen.
[AGENT][NEUTRAL] Yeah, typically there would be a policy or a certificate number on there um or a member ID but I we can't look it up for member IDs um their member IDs it's a little bit harder to find.
[CUSTOMER][NEUTRAL] It doesn't
[CUSTOMER][NEUTRAL] Oh really? Yeah, it says employee ID, but the other ones I don't see anything like that on there.
[AGENT][NEUTRAL] I'm not seeing anything for durable medical equipment.
[CUSTOMER][NEGATIVE] And there's like so many webs and websites and phone numbers I was confused.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Not seeing anything.
[AGENT][NEUTRAL] That allows for durable medical equipment, but let me, let me look through his policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Helps if I spell it right sometimes.
[AGENT][NEGATIVE] Yeah, that would have been under his uh his hospital indemnity plan and I'm not showing anything for durable medical equipment.
[CUSTOMER][NEUTRAL] OK, so then he just has part A.
[CUSTOMER][NEUTRAL] I say no partly.
[CUSTOMER][NEUTRAL] Right, and then when did his policy become effective?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK. Um, do you want the policy number for his hospital indemnity?
[CUSTOMER][NEUTRAL] Um, I can go ahead and put that on there, so it's for the hang on hospital.
[CUSTOMER][NEUTRAL] Could you spell that other one please?
[AGENT][NEGATIVE] Indemnity, oh, I'm gonna have to Google through. Give me a second. I can't do it in my head.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Because
[AGENT][NEUTRAL] Here we go. I am.
[CUSTOMER][NEUTRAL] That's like me either. So I was like uh.
[AGENT][NEUTRAL] IN
[AGENT][NEUTRAL] D E
[AGENT][NEUTRAL] M N
[AGENT][NEUTRAL] I T Y.
[CUSTOMER][NEUTRAL] OK. All right, thank you. So, and policy number for that, OK.
[AGENT][NEUTRAL] OK, it's 02.
[AGENT][NEUTRAL] 543253.
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] Which I'm gonna pass all this information on to billing um can I get a.
[CUSTOMER][NEUTRAL] A claims address or a PO box.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, and I didn't answer his question. This policy has the effective date of [PII].
[AGENT][NEUTRAL] I think you asked that earlier.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And claims will be submitted to IMA.
[AGENT][NEUTRAL] And that is [PII].
[AGENT][NEUTRAL] In [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you need their payer ID?
[CUSTOMER][NEUTRAL] Um, please.
[AGENT][NEUTRAL] It's 645-56.
[CUSTOMER][POSITIVE] OK. All right. I guess that's all I need. I mean anything else they should, they can call and find out about, um, OK, thank you so much for your help.
[AGENT][NEUTRAL] OK. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] You have a good day.
[AGENT][POSITIVE] Alright, thank you for calling APL.
[CUSTOMER][NEUTRAL] No ma'am, I think that'll be all.
[AGENT][POSITIVE] Have a great day.
[CUSTOMER][POSITIVE] You're welcome. Thank you. You too, bye-bye.
[AGENT][NEUTRAL] Bye.