AccountId: 011433970860
ContactId: 06e35cd9-22b5-4f23-8621-e8192e2d34df
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 644960 ms
Total Talk Time (AGENT): 159620 ms
Total Talk Time (CUSTOMER): 235418 ms
Interruptions: 2
Overall Sentiment: AGENT=0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/06e35cd9-22b5-4f23-8621-e8192e2d34df_20250507T14:17_UTC.wav
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[CUSTOMER][NEUTRAL] Available.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I actually.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hi, this is [PII] with American Public Life. How can I help?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] calling from provider office. Need to check eligibility for one patient.
[AGENT][POSITIVE] All right. I'm happy to check on eligibility. Can I get the patient policy number?
[CUSTOMER][NEUTRAL] Mhm, just a second.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Alright, give me just one moment please. Let me take a look.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] is.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] What is the patient's first name, last name?
[CUSTOMER][NEUTRAL] First name is [PII] and last name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] That did not bring up that member. Can you spell their name or do you have their social, anything else?
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] I have no patient phone number.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] I can look by name. Can you spell their name?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, just a 2nd. 1st name or last name?
[AGENT][NEUTRAL] Last name first.
[CUSTOMER][NEUTRAL] It's the first name is.
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[CUSTOMER][NEUTRAL] And 1st 1st name is [PII].
[AGENT][NEUTRAL] OK. Let me try by name.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] like I really.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] All right
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So, with that information, [PII], I'm unfortunately not able to locate a member plan.
[AGENT][NEUTRAL] So I do not see any active.
[CUSTOMER][NEUTRAL] But actually it's a previous.
[CUSTOMER][NEUTRAL] No, actually, the previous rap aviation is found by their mobile number for patient for contact number.
[AGENT][NEUTRAL] We don't have a way to look up a patient by phone number. We can only look them up by name or social.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Name and social, just a second.
[CUSTOMER][NEUTRAL] Yes, can you find out that I have another social [PII].
[AGENT][NEUTRAL] Let me try that.
[AGENT][NEUTRAL] The [PII] is the valid member ID, so notate that down that that's the policy number.
[CUSTOMER][NEUTRAL] It's incorrect member ID, right?
[AGENT][NEUTRAL] That's the member ID and they're active with an effective date of [PII].
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] So, can you provide me also group policy number?
[AGENT][NEUTRAL] The group number is that what you need?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Group number is 70084.
[CUSTOMER][NEUTRAL] And what's the group name?
[AGENT][NEUTRAL] Surge staffing.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so can you provide me the my providers in network or out of network?
[AGENT][NEUTRAL] So for this particular plan, there's no network required for usage.
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] The plan pays by UCR it does participate in the Carrington PPO network.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Plan
[AGENT][NEUTRAL] Was there any other information that I can help with here today?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm sorry, your phone cut out. What was that?
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Mhm. What other information can I help with [PII]?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] So can you provide me the how much makes and used.
[AGENT][NEUTRAL] So the calendar year max is $750.
[CUSTOMER][NEUTRAL] your
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Patient has a $50 deductible.
[CUSTOMER][NEUTRAL] And how much you used?
[AGENT][NEGATIVE] They have not used anything for the year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and is there any missing cloths and waiting area?
[CUSTOMER][NEUTRAL] I mean.
[AGENT][NEUTRAL] Policy does have a missing tooth claws, no waiting period.
[CUSTOMER][NEUTRAL] And OK, is there any, ah, is it a downgrade or downgrade of posterior composite?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Do you know the.
[CUSTOMER][NEUTRAL] No, so can you provide me the percentages just the 16 calls?
[AGENT][NEUTRAL] Can I provide you what again? I'm sorry.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Can you uh give me the percentages?
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Yeah, so members plan has preventative and basic coverage only.
[AGENT][NEUTRAL] Preventative is covered at 100%.
[CUSTOMER][NEGATIVE] No, no.
[AGENT][NEUTRAL] And basic is at 80.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It in no major, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And can you provide me the frequencies?
[AGENT][NEUTRAL] Prophy is once every 6 months. Oral evaluation, 2 for 12 month, bite wing is once per 12 months, and full mouth X-rays and panos are once every 5 years.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] What about bike wings? It's one bike.
[AGENT][NEUTRAL] Fight wings or once per 12 months.
[CUSTOMER][NEUTRAL] And OK. And what about FMX?
[AGENT][NEUTRAL] Once per 5 years.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what about fluoride 1208?
[AGENT][NEUTRAL] 1208 is not listed, therefore it's not covered.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Not. OK.
[CUSTOMER][NEUTRAL] And patient has any preventive his[PII]?
[AGENT][NEGATIVE] No history on file.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Noone. And can you provide your name?
[AGENT][NEUTRAL] My name is [PII], that's [PII]
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] And can you provide me the call reference number for this call?
[AGENT][NEUTRAL] Call references my name with my last initial in today's date. The initial to my last name is [PII], then today's date.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] OK, [PII], thanks for your help. I done my patience.
[AGENT][NEUTRAL] You have another one that you need to check as well?
[CUSTOMER][POSITIVE] No, just thanks for the help. I I'm a patient.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yeah, so did you have another patient or is that it?
[CUSTOMER][POSITIVE] Mm, no, no, just thanks for the help.
[AGENT][POSITIVE] You're welcome bye bye bye