AccountId: 011433970860
ContactId: 111f6e3d-453a-4466-867e-273f42b9a96c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209860 ms
Total Talk Time (AGENT): 104846 ms
Total Talk Time (CUSTOMER): 69185 ms
Interruptions: 2
Overall Sentiment: AGENT=1.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/111f6e3d-453a-4466-867e-273f42b9a96c_20250220T20:33_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, I was calling to find out eligibility and see if we're even in network with your insurance.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the eligibility and the network. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[CUSTOMER][NEUTRAL] I wouldn't.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] I don't have a policy number. I have his social.
[AGENT][NEUTRAL] OK. Oh, that's fine.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] 984-792
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] So basically an offer.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] I'm just waiting for them to populate here. Hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, this is [PII]. And then just the date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And this is for the medical policy.
[CUSTOMER][NEUTRAL] Dental.
[AGENT][NEUTRAL] Dental, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So that policy number is 233.
[AGENT][NEUTRAL] 0419.
[CUSTOMER][NEUTRAL] this is
[AGENT][NEUTRAL] And the policy has been active since [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm pulling up their um policy type now, the medical had populated. Hold on one second.
[CUSTOMER][NEUTRAL] The address for this
[CUSTOMER][NEUTRAL] Insurance and.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I'm just trying to so that I don't uh uh more for that.
[AGENT][NEUTRAL] OK, did you have particular questions about the fax back or did you just need a copy of it?
[CUSTOMER][NEUTRAL] Are we in network with you guys?
[AGENT][NEUTRAL] Well, this particular policy isn't on a network. It uses, um, well, the
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] I guess you can say the carrier is Carrington, but this, this particular policy doesn't have like Carrington PPO or HMO. It's just, um, it goes by UCR.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I know, but I don't know where I'm just talking about this sorted out and then.
[CUSTOMER][NEUTRAL] Yeah I know
[AGENT][NEUTRAL] And the percentages.
[CUSTOMER][NEUTRAL] OK, yeah, if you could just fax me the.
[AGENT][NEUTRAL] Sure, so on the, on the fax back, you'll see the calendar year maximum deductible, all the percentages, any waiting periods, frequencies, um, limitations and exclusions, all the ways to file a claim, and then there's a list of covered codes. If the code you're looking for is not on this list, it wouldn't be covered by this policy.
[CUSTOMER][NEUTRAL] Breakdown
[CUSTOMER][POSITIVE] Perfect thank you so much.
[AGENT][NEUTRAL] You're welcome, [PII]. What's a good fax number for you?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alright, well, I'll go ahead and send this over to you now. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um, no, that was it.
[AGENT][POSITIVE] Alright, well, thank you so much for calling APL and I do hope you have a great day.
[CUSTOMER][POSITIVE] All right you too.
[AGENT][POSITIVE] Thank you. Bye-bye.