AccountId: 011433970860
ContactId: 300eab1d-5224-47e3-9857-a4fa656f64bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 469670 ms
Total Talk Time (AGENT): 123300 ms
Total Talk Time (CUSTOMER): 94741 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/300eab1d-5224-47e3-9857-a4fa656f64bc_20250218T22:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I need to check the eligibility of a patient, [PII].
[AGENT][NEUTRAL] OK, um, may I get your name please and your callback number?
[AGENT][NEUTRAL] And the facility you're from?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] What's your name?
[CUSTOMER][NEUTRAL] Uh my name is [PII].
[CUSTOMER][NEUTRAL] The phone number is [PII].
[AGENT][NEUTRAL] OK, and what is the name of the facility?
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It's Dr. Gardner Way's office Cosmetic and Family Industry.
[AGENT][POSITIVE] OK, thank you so much. And then what is [PII]'s uh date of birth and policy number?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[CUSTOMER][NEUTRAL] Member ID is 616994.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy with us. Her effective date is [PII], and if you give me your fax number, I'll send you a fax back with their complete benefit breakdown.
[CUSTOMER][NEUTRAL] OK, well, I have her max and the like her history and everything on it.
[AGENT][NEUTRAL] It'll have her max now her history I'll have to look up for you but it'll have all the benefits the max where you send the payment to deductible.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Alright, I just have like 4 questions. Could you answer that here instead of doing the back?
[AGENT][POSITIVE] Yes, I can do that for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look them up, look up her.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me look up her
[AGENT][POSITIVE] Um, benefits real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, I've got her benefits pulled up now.
[CUSTOMER][NEUTRAL] OK, um, I just, how much is remaining from her maximum?
[AGENT][NEUTRAL] Let me check.
[CUSTOMER][NEUTRAL] Or has she used any?
[AGENT][NEUTRAL] Let's look and see.
[AGENT][NEUTRAL] OK, she has not used anything this year. Oh wait, let me go one more, one more screen just a second.
[AGENT][NEUTRAL] OK, she still has her $50 deductible left to pay and she still has her benefit amount of $1000 and this is just to verify her benefits it's not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm. And is she eligible for an exam in cleaning?
[AGENT][NEUTRAL] OK, can you give me the uh procedure code so I can look it up by procedure code to see when her last one was done. She gets one every 6 months.
[CUSTOMER][NEUTRAL] Yeah, it's 0120.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh that's the first one.
[AGENT][NEUTRAL] OK, let me look her up.
[AGENT][NEUTRAL] OK, it looks like she had her last one done on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The cleaning and exams and everything.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] That was the 0120.
[AGENT][NEUTRAL] Procedure code. What's the next one?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 1110.
[AGENT][NEUTRAL] She also had um the cleaning done on [PII].
[CUSTOMER][NEUTRAL] OK, and is, uh, how about 0274?
[AGENT][NEUTRAL] And she's never had that done.
[CUSTOMER][NEUTRAL] OK and 0330.
[AGENT][NEUTRAL] And that has not been done either.
[CUSTOMER][NEUTRAL] Alright, and 02, excuse me.
[CUSTOMER][NEUTRAL] 0210
[AGENT][NEUTRAL] That last time she's had that done was [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, that should be all I needed. Thank you for your help.
[AGENT][POSITIVE] You're very welcome. You have a good rest of your night and thanks for calling APL.
[CUSTOMER][POSITIVE] Mhm thank you.
[AGENT][NEUTRAL] Bye bye [PII].