AccountId: 011433970860
ContactId: 00438cfa-e829-4842-8581-a28296e7c085
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 263440 ms
Total Talk Time (AGENT): 94541 ms
Total Talk Time (CUSTOMER): 101156 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/00438cfa-e829-4842-8581-a28296e7c085_20250317T17:11_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Good morning. My name is [PII]. I'm calling from Somo and [PII] trying to check eligibility for a patient plan. Could you assist me with this?
[AGENT][POSITIVE] I'd be happy to assist with eligibility. Can you repeat your first name for me?
[CUSTOMER][NEUTRAL] Yes, it is [PII] again.
[AGENT][POSITIVE] And and if I can get a good call back number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and what is the um policy number?
[CUSTOMER][NEUTRAL] It is 02598347.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] and date of birth [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII]. And were you needing a fax back breakdown of the benefits?
[CUSTOMER][POSITIVE] Uh, yes, but I, you are able to give me another benefits through the phone, that would be great as well.
[AGENT][NEUTRAL] OK, now the only thing we wouldn't do verbally is the um frequency and coding that would have to be faxed over.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm, did you need the fax number sorry.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] I'm ready for that fax.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Alright, you should receive that fax within the next 10 minutes.
[CUSTOMER][NEUTRAL] Thank you. And by any chance, ma'am, did you know if this plan is a calendar year or fiscal?
[AGENT][NEUTRAL] It's calendar and the calendar max is $500 per calendar year and patient does have a $50 individual deductible and $150 family deductible and he has not met that he hasn't used any benefits and he doesn't have any history.
[CUSTOMER][NEUTRAL] Thank you. And is there any waiting period or missing tooth class?
[AGENT][NEGATIVE] No waiting period, but there is a missing tooth cloth.
[CUSTOMER][NEUTRAL] Got it. And what is the coordination of benefits?
[AGENT][NEUTRAL] We don't coordinate benefits.
[CUSTOMER][NEUTRAL] Got it. And those plans have or the benefits.
[AGENT][NEUTRAL] No, no Ortho.
[CUSTOMER][POSITIVE] Oh thank you and you say the facts contain the procedure code with the frequencies and the percentage of the cover.
[AGENT][NEUTRAL] Yes, um, that will be on the fax back if you don't see the code listed, that means it's not a covered benefit.
[CUSTOMER][NEUTRAL] OK, thank you. And before I let you go, can I get the reference number for the call, please?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call. Was there anything else I can assist with today?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Uh, no, I just want to confirm, uh, the name of the insurance. Is it still Carrington or a different carrier?
[AGENT][NEUTRAL] It's American Public Life.
[CUSTOMER][NEUTRAL] OK, got it. Um, could you give me the insurance mailing address, please?
[AGENT][NEUTRAL] OK, that'll be on the fax back but it's [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][POSITIVE] Got it thank you so much, ma'am. I, and I think that it's all the information what I'm looking for today. I really appreciate it and have a great one.
[AGENT][POSITIVE] Thank you for calling APL you have a good day.
[CUSTOMER][NEUTRAL] What
[AGENT][NEUTRAL] Bye.