AccountId: 011433970860
ContactId: 504b8f99-7786-4755-8586-6f349a39a65b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 315730 ms
Total Talk Time (AGENT): 125100 ms
Total Talk Time (CUSTOMER): 92292 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/504b8f99-7786-4755-8586-6f349a39a65b_20250527T20:04_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, I got a fax back, but I just need, I had a couple questions about um what fell under the basic for my patient.
[AGENT][NEUTRAL] OK, so you've received the fax back, but you still have additional questions. Is that correct?
[CUSTOMER][NEUTRAL] I just need some
[CUSTOMER][NEUTRAL] Yes ma'am mhm.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes, I can help you. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name's [PII].
[AGENT][NEUTRAL] OK, [PII]. And how do you spell your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And your callback number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number, please?
[CUSTOMER][NEUTRAL] It is 02625461.
[AGENT][POSITIVE] OK, [PII], thank you one moment.
[AGENT][NEUTRAL] OK, and any information that is provided will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, it's [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, let me get her fax that pulled up. It was sent to you, just one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so your fact that should have been a total of 4 pages.
[CUSTOMER][NEUTRAL] Mm, oh hold on, it might have came through later.
[AGENT][NEUTRAL] On the first page it has.
[CUSTOMER][NEGATIVE] I apologize I did not see that and it didn't.
[CUSTOMER][NEUTRAL] Because on my second page it said American Fidelity page too. The rest of them say the numbers, OK.
[CUSTOMER][NEGATIVE] Well, I just wasted yours and my time.
[AGENT][NEUTRAL] Oh, that, no, that's OK. I just wanna make sure you receive the link because it does, uh, starting on page two, it lists out the different codes, descriptions, the limitation, and which category they fall under.
[CUSTOMER][NEUTRAL] OK, that's perfect, thank you. Um, the ANC. I just see where it says shows limitations A and C. I'm just, I don't wanna have to call back again, so I'm trying to look to make sure that tells me.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] So what's the breakdown for the a like limitation where it shows like on um fluoride.
[AGENT][NEUTRAL] That'll be on the very last page. Mhm. If you look on page 404, that's where the limitation code.
[CUSTOMER][NEUTRAL] Last name
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Definitions are.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] On mine the last page it says maximum. OK, that now I see what you're talking about. OK, this is a weird one. I've never.
[AGENT][NEUTRAL] You should have like a parenthesis, like under the word limitation, you should have A and then.
[CUSTOMER][NEUTRAL] I see yeah.
[AGENT][NEUTRAL] The description.
[CUSTOMER][POSITIVE] I see it, thank you so much for your help.
[AGENT][POSITIVE] Oh, you're welcome. Is there anything else that I could help you with, [PII]?
[CUSTOMER][POSITIVE] No, that that should be it. I appreciate your help.
[AGENT][NEUTRAL] Absolutely. Well, you're welcome and I don't know if when you called in a while ago they told you or not, but if you end up filing a claim with us for this member, once the claim has been processed, we do have a portal that you should be able to check our claim status in.
[AGENT][NEUTRAL] Did they give you that website?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] They did not.
[AGENT][NEUTRAL] OK, the website for that is secured. [PII].
[CUSTOMER][NEUTRAL] I'm sorry, AM what?
[AGENT][NEUTRAL] [PII]. Uh-huh.
[CUSTOMER][NEUTRAL] [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] To just check status, would you be able to do verification eligibility after that?
[CUSTOMER][NEUTRAL] Um, with that website or is it just the.
[AGENT][NEUTRAL] You cannot, no, at this time, no, ma'am. That is strictly for claims.
[CUSTOMER][POSITIVE] OK all right well thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right. Well, you're very welcome. So again, if that's all I can help you with, [PII], thank you for calling again today and I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Uh, you're welcome bye bye.