AccountId: 011433970860
ContactId: fae36143-4f3d-44e8-9772-6ef8547af9f0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 315500 ms
Total Talk Time (AGENT): 113755 ms
Total Talk Time (CUSTOMER): 148243 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/fae36143-4f3d-44e8-9772-6ef8547af9f0_20250102T14:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi [PII], good morning. This is uh [PII] from Edge Park on a recorded line and I would like to verify benefits and eligibility of, uh, one of the members. So hope you could assist.
[AGENT][NEUTRAL] OK, I can barely hear you.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, let me speak up. What about now? Is it better?
[CUSTOMER][NEUTRAL] Is it better?
[AGENT][NEUTRAL] OK, what's your name?
[CUSTOMER][NEUTRAL] Uh, [PII], uh spelled as [PII] and then [PII] Last name is [PII]. Again, I'm calling from Edge Park on a recorded line.
[AGENT][NEUTRAL] OK, and I'm sorry, you're checking claim status or did you say eligibility and benefits?
[CUSTOMER][NEUTRAL] Uh, eligibility and benefits.
[AGENT][NEUTRAL] OK, and is this for service in a doctor's office?
[CUSTOMER][NEUTRAL] Uh, it's for DME specifically for HP code A for yes, A for apple 4239.
[AGENT][NEUTRAL] DME. OK, thank you.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] Policy number. OK, let me get that. One moment, please.
[CUSTOMER][NEUTRAL] 02486800.
[AGENT][NEUTRAL] OK, what's a good phone number, uh, [PII], in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Free, that is correct.
[AGENT][NEUTRAL] OK, what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, this is for [PII], [PII].
[AGENT][NEUTRAL] Alright, thank you for that information. I show the policy effective date is [PII]. Policy is active at this time, and you said for durable medical equipment, did you give me a DME code?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, it's, yes, uh, A for apple, 4239.
[AGENT][NEUTRAL] 423-39.
[CUSTOMER][NEUTRAL] A for apple, 4239.
[AGENT][POSITIVE] Mhm. Thanks.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And what is that for? A glucose monitor?
[CUSTOMER][NEUTRAL] Yes, right, sensor.
[AGENT][NEUTRAL] OK, so I do show that this policy has a DME writer. Um, the, uh, DME uh equipment is considered under the outpatient benefit which is up to $3000. That is per calendar day.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] And any information provided is verification, not a guarantee of payment, and currently of that amount for [PII] I don't show any used.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Of course it's a per calendar day benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, yes, right, start of the year, uh, is there a group number?
[AGENT][NEUTRAL] Uh, the group number is 80059. If you have a copy of the ID card, it should be on that card as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, that's 866 059.
[AGENT][NEUTRAL] 80059.
[CUSTOMER][NEUTRAL] 0, 80059 and uh what's the plan type HMO PPO?
[AGENT][NEUTRAL] a supplemental Metin gap policy.
[CUSTOMER][NEUTRAL] So it's a supplemental uh C supplemental C.
[AGENT][NEUTRAL] The type of policy is a Metlink supplemental policy. It's secondary to the major medical plan.
[CUSTOMER][NEUTRAL] Yes, OK, it's uh supplemental, right? Medin.
[AGENT][NEUTRAL] It's a Metlink policy, ma'am.
[CUSTOMER][NEUTRAL] Just wanna make sure.
[CUSTOMER][NEUTRAL] OK, OK, got it. And uh let me just make sure I, and it's a calendar year, so no deductible, or?
[AGENT][NEUTRAL] Yeah, the benefit is up to $300 per calendar day, no deductible.
[CUSTOMER][NEGATIVE] Zero deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, I'm sorry, I'm just checking what I need to, uh, know, and out of pocket that's the $300 right?
[AGENT][NEUTRAL] I'm not sure I understand the question.
[CUSTOMER][NEUTRAL] OK, that's fine. So that's OK, I think that's all I need for now. OK, so thank you so much. uh, so since this is supplemental meddling, uh, meddling policy, no authors required?
[AGENT][NEUTRAL] No authorization is required.
[CUSTOMER][NEUTRAL] Is
[CUSTOMER][POSITIVE] OK, got it, so I think that's all I need for now. Thank you so much. Can I just ask for a call reference number please?
[AGENT][NEUTRAL] You'll use my name in today's status reference for today's call. First initial of my last name is [PII]. Any other questions I can help out with today?
[CUSTOMER][NEUTRAL] Uh no, so I'll use your name. uh [PII]
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and today you say.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All [PII]. Anything else?
[CUSTOMER][POSITIVE] Happy [PII]. Bye-bye. No, that's it. Appreciate your help. Bye bye.
[AGENT][POSITIVE] Alright, thank you for, thank you for calling APLSL. Have a good day as well.