AccountId: 011433970860
ContactId: 67306882-a814-4bd0-b483-e96df773b589
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 193240 ms
Total Talk Time (AGENT): 95975 ms
Total Talk Time (CUSTOMER): 74118 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/67306882-a814-4bd0-b483-e96df773b589_20250114T20:04_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi Ms. [PII], my name is [PII]. I was calling to get possibly like either a fax back or a full breakdown of benefits for a patient.
[AGENT][NEUTRAL] OK. Well, I can help you with the um dental benefits. And [PII], may I have a good contact number in case we're disconnected and then the member's policy number?
[CUSTOMER][NEUTRAL] Yes, our phone number [PII].
[CUSTOMER][NEUTRAL] And then the policy number is 025.
[CUSTOMER][NEUTRAL] 21252.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, so the subscriber is [PII]. Date of birth [PII], but I am calling for someone else that may be on the plan.
[AGENT][NEUTRAL] OK. And what's that member's uh name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth [PII].
[AGENT][NEUTRAL] All [PII], and thank you for verifying her information and all the information provided is a verification of benefits, not a guarantee of payment. Um, so if you'd like, I can fax you over the fax back or if you have particular questions from the fax back, um, I can help you with that. Um, but there's no history on file for [PII] as of yet. We haven't, um, processed any claims for her yet.
[CUSTOMER][NEUTRAL] OK, no history of file. Will it show like a full breakdown of benefits like frequency and.
[AGENT][NEUTRAL] So it'll show
[AGENT][NEUTRAL] Mhm. So it'll show the calendar year max, the deductible, all the percentages, waiting periods, frequencies, um, all the limitations, exclusions, the three ways to file a claim, and then there's a list of covered codes. If the code you're looking for is not on this list, then it won't be, it won't be covered by the policy.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] OK perfect and I think she was trying to say that like there isn't like a PPO is it just UCR fees?
[AGENT][NEUTRAL] Um, so yes, this is the UCR, um, and so like the, well, did you want the percentages or you wanna wait for it?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I can wait for the fax.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] You sure? OK. What's a good fax number for you, [PII]?
[CUSTOMER][NEUTRAL] Yeah, it's fine.
[CUSTOMER][NEUTRAL] Um, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, and should I put attention, [PII]?
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Alright, so I am sending this over to you now. And was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Uh, no, but thank you so much. You've been a great help.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL [PII]. I hope you have a great day and happy New Year.
[CUSTOMER][POSITIVE] Oh happy [PII] to you too thank you.
[AGENT][POSITIVE] Thank you. You're welcome. Bye-bye.