AccountId: 011433970860
ContactId: 340bc147-46cc-406c-a7a8-78f2f867e2ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 155399 ms
Total Talk Time (AGENT): 79282 ms
Total Talk Time (CUSTOMER): 74646 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/340bc147-46cc-406c-a7a8-78f2f867e2ea_20250320T15:10_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thanks for calling APO. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], uh, this is [PII] calling from the, uh, provider's office needing to verify data benefits.
[AGENT][NEUTRAL] Sure, I can assist you with that, [PII]. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Uh yes, [PII].
[CUSTOMER][NEUTRAL] It's the contact number and then the policy number is 02606784.
[CUSTOMER][NEUTRAL] They they might do, but I pay for.
[AGENT][NEUTRAL] Could you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, it's [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] [PII], this policy has been active since [PII] and is currently active.
[CUSTOMER][NEUTRAL] Alrighty, and if I could just get like a breakdown as far as percentages maximum deductibles.
[AGENT][NEUTRAL] This policy has a maximum benefit amount of $500 per calendar year with a $50 deductible that does not apply to his preventative services. This is not a guaranteed benefits, just a disclaimer on the policy's coverage. Preventative is covered at 100% and basic is covered at $80. The policy is very limited, so unfortunately it does not cover major.
[AGENT][NEUTRAL] Perio endo um oral surgery, crowns, bridges, partials, dentures.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Ortho and I can send you a fake back if you would like.
[CUSTOMER][POSITIVE] Yes, that'd be awesome. So this only basically covers diagnostic preventative and just like what fillings restorative.
[AGENT][POSITIVE] Yes, that is correct and simple extractions.
[CUSTOMER][NEUTRAL] Got you. Sims [PII].
[AGENT][NEUTRAL] What's your fax number, [PII]?
[AGENT][NEUTRAL] I have [PII].
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] And you did say your name was [PII] correct cause I changed your name in a minute.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, is there anything else that I can assist you with? The member has no history on file, nor has he utilized any of his benefits for [PII] or met his deductible.
[CUSTOMER][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Got you. And is the fee schedule Carrington?
[CUSTOMER][NEUTRAL] So I have an 11 available.
[AGENT][NEUTRAL] This policy is a Carrington network. however, the member does not have to utilize the Carrington network provider because it's a PPO.
[CUSTOMER][NEUTRAL] Got you. OK, alright, well you just answer everything you were off.
[AGENT][NEUTRAL] And any procedure codes that's not listed?
[AGENT][NEUTRAL] Means that it's not covered under the policy.
[CUSTOMER][POSITIVE] Got you. OK, alright, well I greatly appreciate you. What is your email?
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APL. Have a great day. Goodbye.
[CUSTOMER][NEUTRAL] You as well bye bye.