AccountId: 011433970860
ContactId: 11ed77b1-d32e-4de1-ae46-434f6b2b4258
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 208949 ms
Total Talk Time (AGENT): 84450 ms
Total Talk Time (CUSTOMER): 138626 ms
Interruptions: 5
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/11ed77b1-d32e-4de1-ae46-434f6b2b4258_20250108T18:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hey, [PII]. This is uh [PII] calling from the provider's office to check the eligibility and benefits of a patient. Can you please help me out with that?
[AGENT][POSITIVE] Of course I can check eligibility and benefits for you [PII]. Uh, can I get a good call back number for you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh yes, uh, sure. The callback number, that will be, uh,
[CUSTOMER][NEUTRAL] Yeah, that is uh [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Uh, uh, the member ID number, right?
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] Yes, uh, that will be uh 02510234.
[AGENT][NEUTRAL] OK, thank you. One moment please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, the policyholder's name I have, it's uh [PII] with the date of birth of uh [PII].
[AGENT][NEUTRAL] OK, is that the patient you're gonna be seeing?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No, uh, the patient's name is uh [PII] with the date of birth of uh [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying that information, [PII]. Alright, so this policy is active. Effective date was [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And uh did you, I could send you the uh copy of the fax back that shows all covered procedures and benefit information if you'd like.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh yes, please.
[AGENT][NEUTRAL] OK, what's that fax number for you?
[CUSTOMER][NEUTRAL] Uh, the fax number is [PII].
[AGENT][NEUTRAL] OK, I'm gonna read that back, make sure that I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, and would I just put this to your attention, [PII]?
[CUSTOMER][NEUTRAL] Uh, yes, yes, you can use money.
[AGENT][NEUTRAL] OK, alright, I will get that sent to you. You should get it here in maybe 10-15 minutes depending on how busy your machine is. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, no, so I, I just want to confirm, uh, so, uh, the, uh, the procedures which is not available, the facts, uh, is it, uh, considered as not covered?
[AGENT][NEUTRAL] That's correct. If you're looking for a procedure and you don't see it on the fax back, that means it's not a covered procedure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, um, thank you for that. And so, uh, these, uh, uh, the benefits on the fact, uh, will be code specific, right?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Right, yes.
[CUSTOMER][NEUTRAL] OK, perfect. Thank you so much for that. And so, uh, yeah, so, um, uh, so I just want to confirm one more thing. So, uh, this the, uh, provider participation, uh, does it follow the caring time?
[AGENT][NEUTRAL] Yes, Carrington PPO.
[CUSTOMER][NEUTRAL] Carrington, uh, they provide us, uh, participation is according to the Carrington, right?
[AGENT][NEUTRAL] Correct, uh, utilization of a provider in the Carrington network is not required, but this policy does participate in the Carrington PPO.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, perfect. Thank you for that. And so in that case, uh, that will be all. Thank you so much for uh helping me out today and have a great day.
[AGENT][NEUTRAL] I
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL, [PII]. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Yeah take care bye bye.
[AGENT][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] Yeah