AccountId: 011433970860
ContactId: 164bc398-e822-41fb-a08d-9ad041da1629
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204419 ms
Total Talk Time (AGENT): 85762 ms
Total Talk Time (CUSTOMER): 78671 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/164bc398-e822-41fb-a08d-9ad041da1629_20250513T14:42_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. Um, I'm calling for eligibility and benefits for a patient.
[AGENT][NEUTRAL] OK, I verify benefits and eligibility for you, Ms. [PII]. And what is that policy number, please?
[CUSTOMER][NEUTRAL] He doesn't have it. um, am I able to use a social if I can get it?
[AGENT][NEUTRAL] Is it the policyholder's social?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Uh, what's the patient's name? I can look it up by name.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] What's that last name?
[CUSTOMER][NEUTRAL] Last name [PII]
[AGENT][NEUTRAL] OK. And the date of birth?
[CUSTOMER][NEUTRAL] Let me check.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah she's almost
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. Give me one moment.
[CUSTOMER][NEUTRAL] 3
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, I do. It's [PII].
[AGENT][NEUTRAL] And this is for dental
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. Let's see. Uh, when you're ready, I can give you his policy number.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Awesome I'm ready.
[AGENT][NEUTRAL] OK, it is 250-2882.
[AGENT][NEUTRAL] His effective date is [PII] and is active. And do you just need general breakdown of benefits or I can send you a fax back?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] thank you.
[CUSTOMER][NEUTRAL] Um, does the fax back it's gonna have general breakdown.
[AGENT][NEUTRAL] Yes, ma'am, uh, limitations frequencies.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yeah, and then are you able to tell me if uh he's in network with our office?
[AGENT][NEUTRAL] Well, we don't have a network, uh, with our, with this policy, it pays by UCR.
[CUSTOMER][NEUTRAL] Just give me one moment.
[CUSTOMER][NEUTRAL] Pays by UCR uh.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, and what's your fax number?
[CUSTOMER][NEUTRAL] Yes, let me get that for you [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and that's [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you, ma'am. And is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Yeah, um, what does it mean when you say it pays by UCR?
[AGENT][NEUTRAL] Usual customary reasonable, it doesn't pay by a fee schedule.
[CUSTOMER][NEUTRAL] Hm, OK, so on the fax is it gonna have the PO box that we can send the claim to and everything?
[AGENT][NEUTRAL] Yes, it's gonna have the PO box fax number as well as the payer ID.
[CUSTOMER][POSITIVE] OK, I appreciate that thank you so much.
[AGENT][POSITIVE] Yes, ma'am. You're welcome. And is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] No, that'll be all thank you.
[AGENT][POSITIVE] Yes, ma'am. Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.