AccountId: 011433970860
ContactId: 234a70ac-228a-48cc-a036-88ef79dc1c33
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 392880 ms
Total Talk Time (AGENT): 209409 ms
Total Talk Time (CUSTOMER): 144632 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/234a70ac-228a-48cc-a036-88ef79dc1c33_20250121T16:36_UTC.wav
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[AGENT][NEUTRAL] For contacting ATO my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I just need to um verify benefits with a fax, but I don't have the participant's date of birth. Is that an issue?
[AGENT][NEUTRAL] Well, we can look at their address as well. What is the, the, I, I'm sorry, with whom am I speaking, please?
[CUSTOMER][NEUTRAL] My name is [PII] and we are at the Lincoln County Health Department. I do have a text. I do not, excuse me?
[AGENT][POSITIVE] Thank you. What's that?
[AGENT][NEUTRAL] Oh, no, uh, your tax ID is fine. Um, I just need to know the policy number please, ma'am.
[CUSTOMER][NEUTRAL] OK, let's see if I can find this on the card we've never, I know that we're out of network. I don't know if there's out of network benefits. I have an employee ID.
[CUSTOMER][NEUTRAL] And that is all that is on the 90 degree card.
[AGENT][NEUTRAL] Oh, OK. Well, that's.
[CUSTOMER][NEUTRAL] There's a group number. I'm sorry, there is a group number which I'm having a very hard time reading. It looks like it might be 9484.
[AGENT][NEUTRAL] Let's see if we can't do it another way. Um, how do you spell their, their last name?
[CUSTOMER][NEUTRAL] There her last name is [PII]
[AGENT][POSITIVE] Thank you. And her first name?
[CUSTOMER][NEUTRAL] [PII] I'm kind of thinking her date of birth might be in [PII]. That's the only thing I have. It's part of her email address.
[AGENT][NEUTRAL] OK, sure. Um.
[AGENT][NEUTRAL] Does it happen to have her address there or do we know her address, part of her?
[CUSTOMER][NEUTRAL] I do have her address. She signed her child, her child's address, hopefully is the same as hers, is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I.
[AGENT][POSITIVE] Wow, OK.
[CUSTOMER][NEUTRAL] Nothing.
[AGENT][NEUTRAL] No, um, let's just see.
[AGENT][NEUTRAL] I've got, I've got a couple of, of daisies.
[CUSTOMER][NEUTRAL] It could
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You said her.
[CUSTOMER][NEUTRAL] With that same last name?
[AGENT][NEUTRAL] Yeah. Now, you said that there was a child, um, what was the child's name?
[CUSTOMER][NEUTRAL] The child's name is [PII]. I have his date of birth.
[AGENT][NEUTRAL] Ah.
[AGENT][POSITIVE] Perfect. What is his date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] That's great.
[AGENT][NEUTRAL] OK, [PII], I think we've got something here. Let's see.
[CUSTOMER][POSITIVE] Fantastic.
[AGENT][NEUTRAL] OK, so whoops.
[AGENT][NEUTRAL] Get that off of there. OK, so her policy number.
[AGENT][NEUTRAL] Uh, for, um,
[AGENT][POSITIVE] Oh goodness.
[AGENT][NEUTRAL] Something
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] Her policy number?
[AGENT][NEUTRAL] Is 02.
[CUSTOMER][NEUTRAL] I can figure that out.
[AGENT][NEUTRAL] 31
[AGENT][NEUTRAL] 9090. Now, that
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] That went into effect on [PII]. Are we looking for dental benefits or medical benefits?
[CUSTOMER][NEUTRAL] Dental benefits. Do you also have her employer who I guess her policy number is attached to her employer. We do not submit claims with policy numbers. Is that something that you will need on the claim?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I think, well, let me see if if we even have this, whether we're even gonna have a problem with this because
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so what the the thing is, yeah, please go ahead.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] No, you go ahead. I'm sure you're gonna be telling me about on the network benefits, correct?
[AGENT][NEUTRAL] Well, no, um, what I'm gonna, what, uh, I have to tell you is that, um, now this is through her employer, uh, first of all, and um.
[AGENT][NEUTRAL] Let's see if I can get the employer name on here so that you can get that. Um the the employer uh name is uh Adept HR A D E T T HR Inc. I think it's uh.
[AGENT][NEUTRAL] Temporary company. So it's adept HR is the name of her company. Now she receives these benefits through her employer, OK? And what she has that is active, OK. Now, she did have dental benefits with us from [PII]. What she has that is active right now, but the others have lapsed. What she has that are active for herself.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] is a is a limited benefit medical policy. So [PII] is not covered at all. Um, so this, this is, this is just for her, and if this is a problem that she needs to uh contact her employer and get that uh resolved, but they have um they have only her um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] As being, uh, as being active. And the medical, the benefits, uh, as I mentioned before, are limited medical. Her dental benefits expired last March.
[CUSTOMER][NEUTRAL] OK, OK, dokey, I will let her know so she has no so [PII] or her son has no coverage at this time, [PII].
[AGENT][NEUTRAL] No, not, not with us. No, if she has some, yeah, not for, not for medical either. Um, so it's only showing her all the way. So if, if she has any questions, she's going to need to go back to her HR and get that resolved. And then what they do is they give us a, a um
[CUSTOMER][NEUTRAL] For dental, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] A, uh, uh, electronic spreadsheet, but I'll also tell you, uh, [PII], that these, these are limited benefit policies. There is no network, so it's not, uh, if, if she does put that in, if she does get that, this is, this is all gonna be with no network. Now is there anything else at all that I can help with while we're on the phone?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] I don't think so, but I thank you for all of your information.
[AGENT][POSITIVE] OK, well, thank you for contacting ATO. You have a very good morning.