AccountId: 011433970860
ContactId: 30c03d50-d172-481f-8296-ffb28efff963
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226509 ms
Total Talk Time (AGENT): 104445 ms
Total Talk Time (CUSTOMER): 106318 ms
Interruptions: 7
Overall Sentiment: AGENT=1.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/30c03d50-d172-481f-8296-ffb28efff963_20250225T20:09_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, I was just trying to get uh eligibility on a patient.
[AGENT][POSITIVE] Sure, I can help you with the eligibility. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] My name is [PII] and the phone number is [PII].
[AGENT][NEUTRAL] Thank you for that. And [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 02560613.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Can you verify the numbers
[CUSTOMER][NEUTRAL] Yes, the first name is [PII], the last name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing that the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] provided a verification of a guarantee and I am showing that the policy is.
[CUSTOMER][NEUTRAL] OK, could you fax that to us?
[AGENT][NEUTRAL] The fax bag?
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Yes, the fax.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Fax what to you?
[CUSTOMER][NEUTRAL] Fax the eligibility.
[AGENT][NEUTRAL] You need like a like a coverage letter?
[CUSTOMER][NEUTRAL] It would be a fax of the eligibilities, um.
[CUSTOMER][NEUTRAL] And let me see because they sent me one before so.
[CUSTOMER][NEUTRAL] Yeah, I'd say
[AGENT][NEUTRAL] OK, um, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah, mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what fee schedule are you guys under?
[AGENT][NEUTRAL] Uh, um, hold on one second. Let me get this one first.
[CUSTOMER][NEUTRAL] Uh, hold on one second, let me.
[AGENT][NEUTRAL] And you said APL sent you a coverage letter for the insured before?
[CUSTOMER][NEUTRAL] Yeah, we've got.
[AGENT][NEUTRAL] Or a fax back of their coverage.
[CUSTOMER][NEUTRAL] We got a fax of their coverage.
[AGENT][NEUTRAL] OK, now that makes sense. I'm like, we don't usually send providers eligibility letters. Um, we send that to the insured, but I can send you a copy of the fax back if you need it. It doesn't have the effective date of the member's policy on it though. It's just like a list of their coverage.
[CUSTOMER][NEUTRAL] This is the coverage, right?
[CUSTOMER][NEUTRAL] This is this is.
[CUSTOMER][NEUTRAL] OK, that's fine.
[AGENT][NEUTRAL] All right, and what's a good fax number for you?
[CUSTOMER][NEUTRAL] Alright, what's good fax number? The phone number is [PII]. Thank you.
[AGENT][NEUTRAL] And does that need to be attention, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, well, I'll go ahead and send the fax back over to you now. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Was
[CUSTOMER][NEUTRAL] What the schedule were you guys under?
[AGENT][NEUTRAL] I'm sorry, so the fee schedule, hold on, let me pull up the facts back.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This one isn't really on a fee schedule, it's just a list of covered codes and then the benefit amount that would be paid to that code or for that code.
[CUSTOMER][NEUTRAL] of
[CUSTOMER][NEUTRAL] amount
[CUSTOMER][NEUTRAL] OK, can you repeat that one more time?
[AGENT][NEUTRAL] Sure, so there's no like fee schedule. I, you can put standard if you have to put anything. It's just a list of procedure codes and then the benefit amount that will be paid for that particular code.
[CUSTOMER][NEUTRAL] So there's no like.
[CUSTOMER][NEUTRAL] you have to
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] All right, so you're welcome. I'll go ahead and fax this over to you now. Is there anything else I can help with?
[CUSTOMER][POSITIVE] Alright thank you.
[CUSTOMER][POSITIVE] You're welcome. I'll go ahead and fax it over to you now.
[CUSTOMER][NEUTRAL] That is
[AGENT][POSITIVE] All right. Well, thanks for calling APL [PII]. I hope you have a good day.
[CUSTOMER][POSITIVE] Thanks for calling AP
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] You're welcome bye bye.