AccountId: 011433970860
ContactId: 1817da02-18c4-46a5-ab81-78a43178572c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 471170 ms
Total Talk Time (AGENT): 90341 ms
Total Talk Time (CUSTOMER): 113722 ms
Interruptions: 5
Overall Sentiment: AGENT=1.3, CUSTOMER=-1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/1817da02-18c4-46a5-ab81-78a43178572c_20250417T16:03_UTC.wav
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[CUSTOMER][NEUTRAL] OK, um, but you.
[AGENT][POSITIVE] Good morning. Thank you for calling APO. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from a provider's office. I was just calling to check if we were in network.
[AGENT][NEUTRAL] OK, sure. I can assist you with network information, Ms. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh huh, [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it is 0257977777.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] So that $104 is.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Mhm. [PII], um, let's see, [PII].
[AGENT][POSITIVE] OK, perfect. Thank you.
[AGENT][NEUTRAL] All right. And this particular policy, Ms. [PII], it doesn't have any network. We pay on the usual and customary rate UCR.
[CUSTOMER][NEUTRAL] Yes ma'am, so the insurance will not cover that. Um, what else, ma'am.
[CUSTOMER][NEUTRAL] your card and your receipt.
[CUSTOMER][NEUTRAL] OK, it, OK, got you, so it doesn't have any network?
[AGENT][NEGATIVE] No, no network.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and then do they have like an annual max?
[AGENT][NEUTRAL] Yes, uh-huh, and this is not a guarantee of payment, just a verification of coverage. We have a calendar year maximum of $1500 with the $50 deductible and deductible does not apply to preventative.
[CUSTOMER][NEUTRAL] You're and we will see you on the [PII].
[CUSTOMER][NEUTRAL] OK, got you, does not apply. Thank you. OK, and do y'all send fax backs of benefits?
[AGENT][NEUTRAL] We do, yes. Would you like one?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] All right. And what is that fax number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes, yes, ma'am.
[AGENT][NEUTRAL] OK. Can I put it on your attention?
[CUSTOMER][NEUTRAL] Yeah sure.
[AGENT][NEUTRAL] OK. Do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Miss [PII]. Yeah, I went ahead and send that over to you. Should be there in a few minutes. Is there anything else I'm gonna help you with today?
[CUSTOMER][NEUTRAL] Um, yes ma'am, I do have one question. So for claims, do we send you the claims or does the patient?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You, you can send the claim in.
[AGENT][NEUTRAL] The provider.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The provider, OK, perfect. And is like um the mailing address gonna be on the fax?
[AGENT][NEUTRAL] The mailing address, yeah, it is in the fax. Um there is the payer ID, the mailing address, and the fax number is in the fax.
[CUSTOMER][POSITIVE] Perfect thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] That's all thank you.
[AGENT][POSITIVE] OK, you're welcome and thank you for calling APL. Have a good day, Miss [PII].