AccountId: 011433970860
ContactId: 29a80d80-fe85-4df7-b48d-74fce8d16fde
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 301989 ms
Total Talk Time (AGENT): 140495 ms
Total Talk Time (CUSTOMER): 99721 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/29a80d80-fe85-4df7-b48d-74fce8d16fde_20250204T19:26_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], and I'm calling on behalf of the office to check on eligibility and benefits on a recorded line.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I could take eligibility and benefits for you. I'm sorry, you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Callback number is [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Policy number is
[CUSTOMER][NEUTRAL] 02554118
[AGENT][NEUTRAL] All right, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII]. Uh, so this policy is active. Effective date was [PII], and if you'd like, I can send you a fax back that shows all covered procedures and benefit information.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. And yes, can you please send me a fax check?
[AGENT][NEUTRAL] Of course. What is that fax number for you, please?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, thank you. I'm just gonna read that back to make sure I heard that correctly that was [PII].
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] Alright, uh, and when I just put this to your attention, [PII]?
[CUSTOMER][NEUTRAL] Hey.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] Would I just put this to your attention?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, alright, I will get that sent to you now. I 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] And I just wanted to check the member's history. Can you please check that for me?
[AGENT][NEUTRAL] History, yes, let me see what I've got. Give me just a moment.
[CUSTOMER][POSITIVE] Mhm. No problem.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I do have a little bit of history on file. Uh, was there a specific code you were looking for?
[CUSTOMER][NEUTRAL] Yes, I wanted to check for the X-rays first.
[CUSTOMER][NEUTRAL] FMX panel and by wings.
[AGENT][NEUTRAL] That's the next panel and black wings, OK.
[CUSTOMER][NEUTRAL] If
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] All righty, bear with me just a moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, I'm not showing that we have any history for, oh well, hang on now there's um procedure code 0210 is that one that you were needing?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I do have one there that was [PII].
[CUSTOMER][NEUTRAL] OK. And the frequency is once in every 5 calendar years, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's the only
[AGENT][NEUTRAL] X-ray panel or um or FMX panel or bite wing. I don't have anything else.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, got that.
[CUSTOMER][NEUTRAL] And is there any history for exams or cleaning? 0120.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] 3120, what was the question? I'm so sorry.
[CUSTOMER][NEUTRAL] History for that
[AGENT][NEUTRAL] Uh, let me see, that was 0120.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, no, I don't have any history for uh that procedure code.
[CUSTOMER][NEUTRAL] OK. And 1110.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] No, I don't have that code either.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And does this member use anything from the annual maximum of $500?
[AGENT][NEUTRAL] I believe so. Give me just a moment, let me check that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, yes, uh, so they did meet the $50 deductible.
[AGENT][NEUTRAL] And they have used $210.60 so far this year.
[CUSTOMER][NEUTRAL] OK, got that. So that's it for today then. What will be the call reference number?
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date and so my name is spelled [PII] Last initial is [PII], was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] No, that's it for today, [PII]. Thank you so much for helping me out today.
[AGENT][NEUTRAL] OK. All right.
[AGENT][POSITIVE] Yeah, thanks for calling [PII]. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too. Have a great one ahead. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] OK.