AccountId: 011433970860
ContactId: 34874aac-6f44-4fb2-8790-7157f6a4130f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 426549 ms
Total Talk Time (AGENT): 131934 ms
Total Talk Time (CUSTOMER): 118649 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/34874aac-6f44-4fb2-8790-7157f6a4130f_20250103T18:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good afternoon. I'm calling from provider's office to verify a patient's eligibility.
[AGENT][NEUTRAL] OK, I can help you with eligibility. Can I please get your name and your call back number just in case the phone is disconnected?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. Number is [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. What is the patient's name?
[CUSTOMER][NEUTRAL] I have [PII].
[AGENT][NEUTRAL] And then what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And his policy number please?
[CUSTOMER][NEUTRAL] Uh, the member ID I have is 01638308.
[AGENT][NEUTRAL] OK, let me look him up real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, you said that policy number is 01638308?
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, that's not pulling in let me see if I can't find him with his name.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me just a second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I do show that [PII] does have an active policy and his effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And I guess the last break that we had was from him was in June, so I just kind of wanna double check that the plan has changed um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What is the current maximum and everything as well as receiving a fax if you can.
[AGENT][NEUTRAL] I can go ahead and send you another fax back um I don't believe anything has changed but we'll send it just to make sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, what is your um fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me um get it pulled up.
[AGENT][NEUTRAL] Give me just a sec while I get that faxed back in.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, I've got the fax back on its way to you.
[CUSTOMER][NEUTRAL] OK, um, can you verify for me the last history on file?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] And what is the name of the facility that you are calling from?
[CUSTOMER][NEUTRAL] I have [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Truemouth dental?
[AGENT][NEUTRAL] OK, what's the doctor's name?
[CUSTOMER][NEUTRAL] Doctor [PII]
[AGENT][NEUTRAL] OK, I do show that the last um data service was [PII].
[CUSTOMER][NEUTRAL] OK perfect and then the panel is was there any panel history?
[AGENT][NEUTRAL] Uh, the procedure code is 00120 and they also had 01110.
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] Right, right, right, um, for any, is there any panel history on file?
[CUSTOMER][NEUTRAL] Our FMX
[AGENT][NEUTRAL] What is the procedure code for that?
[CUSTOMER][NEUTRAL] Um, 0330 or 0210?
[AGENT][NEUTRAL] OK, let me look and see I'm past.
[AGENT][NEUTRAL] And you want me to go back for the year of [PII], is that correct?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Well, I know that, well, the last uh breakdown was that it's covered at 80% and the frequency is once every 5 years, so I just wanna check that there's no panel.
[AGENT][NEUTRAL] Oh, yeah, OK.
[AGENT][NEUTRAL] OK, let me look and see.
[AGENT][NEUTRAL] I don't see one on that data service let me keep looking.
[AGENT][NEUTRAL] OK, it looks like he had the 330 done on [PII].
[CUSTOMER][NEUTRAL] Got you, OK, and it's still 80% correct?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] And there, OK, OK.
[CUSTOMER][NEUTRAL] Alright, um.
[CUSTOMER][NEUTRAL] OK, so then the maximum is still 1500.
[AGENT][POSITIVE] Yes ma'am, that's correct.
[CUSTOMER][POSITIVE] Alright, um, right, hopefully I just get the fax soon so I can have that.
[AGENT][NEUTRAL] Yeah, it's showing that it's sending now. It usually, it's usually there within 3 to 5 minutes.
[CUSTOMER][NEUTRAL] You know how long it usually takes?
[CUSTOMER][POSITIVE] OK awesome.
[CUSTOMER][NEUTRAL] OK, alrighty, and yeah, and can I get your name again the reference number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure. Um my name is [PII]
[CUSTOMER][NEUTRAL] Uh huh
[AGENT][NEUTRAL] And you can use my name in today's date.
[CUSTOMER][POSITIVE] [PII] [PII]. Awesome thank you so much. Happy New Year to you.
[AGENT][POSITIVE] OK thank you Ms. [PII], you have a great day and thanks for calling APL.
[CUSTOMER][POSITIVE] Good
[CUSTOMER][NEUTRAL] I don't know what.
[CUSTOMER][POSITIVE] Forms OK thank you bye bye.
[AGENT][NEUTRAL] Mhm bye bye.