AccountId: 011433970860
ContactId: 21ca7568-8ed5-4fe6-b50e-0362458d013f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 191429 ms
Total Talk Time (AGENT): 74363 ms
Total Talk Time (CUSTOMER): 78388 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/21ca7568-8ed5-4fe6-b50e-0362458d013f_20250617T18:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from our provider's office. I was calling to verify eligibility and benefits for a patient.
[AGENT][POSITIVE] OK. Happy to check on eligibility and benefits today. Do we have a policy number?
[CUSTOMER][NEUTRAL] Yes, I have.
[CUSTOMER][NEUTRAL] Um, 263-534-8.
[AGENT][NEUTRAL] And if I can get patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And are we looking for dental or medical coverage?
[CUSTOMER][NEUTRAL] Dental
[AGENT][NEUTRAL] OK, patient is active. Effective date on here is [PII]. If you need us to, we can also send a fax back with a breakdown of benefits.
[CUSTOMER][NEUTRAL] Um, so I do have that fax on the fax, if it's not listed on there, is that because it's not a covered benefit?
[AGENT][POSITIVE] Correct, yes ma'am.
[CUSTOMER][NEUTRAL] OK. Um, and so this patient, they only have basic, I'm sorry, uh, diagnostic preventative and basic restorative coverage, no major.
[AGENT][NEUTRAL] Correct, yeah, it looks like preventative basic only.
[CUSTOMER][NEUTRAL] OK, um, is it a calendar or a benefit your plan?
[AGENT][NEUTRAL] Calendar year, sorry.
[CUSTOMER][NEUTRAL] No problem. And then is there um
[CUSTOMER][NEUTRAL] Or do you guys go by UCR fees or can you tell me if we're in or out of network?
[AGENT][NEUTRAL] So it does go off of UCR. The plan does participate in the Carrington PPO network if you guys are a part of that, otherwise you would just go off UCR.
[CUSTOMER][NEUTRAL] OK, perfect. Um, has the patient used anything towards their deductible or maximum?
[AGENT][NEUTRAL] They have not.
[CUSTOMER][NEUTRAL] OK, and then I'm assuming they have no history on file?
[AGENT][NEUTRAL] Um, let me, I'll double check just to make sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, yes, correct. No history on file.
[CUSTOMER][POSITIVE] Perfect and lastly, let me just see.
[CUSTOMER][NEUTRAL] Um, can you tell me the group name and number for this plan?
[AGENT][POSITIVE] Yeah, absolutely. So.
[AGENT][NEUTRAL] Group name is Superior Skilled trades.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And group number is 70101.
[CUSTOMER][POSITIVE] Perfect. And if I could get your name again and the reference number for this call, I'll be all set for the day.
[AGENT][POSITIVE] Sounds good. Call reference is my name with today's date. My name is [PII], which is [PII] initial to my last name is [PII], and then today's date.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much for your help today, [PII].
[AGENT][POSITIVE] You're welcome. Have a good one.
[CUSTOMER][NEUTRAL] You too.