AccountId: 011433970860
ContactId: 6b219eac-a7ab-400c-bd32-8cd9e5fbe215
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 239710 ms
Total Talk Time (AGENT): 95100 ms
Total Talk Time (CUSTOMER): 71854 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/6b219eac-a7ab-400c-bd32-8cd9e5fbe215_20241231T19:04_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes, my name is [PII] and I'm calling to check eligibility for a patient dental service.
[AGENT][NEUTRAL] I can
[AGENT][NEUTRAL] How can I help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] I'm so sorry I have 02551089.
[AGENT][NEUTRAL] What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth will be [PII].
[AGENT][NEUTRAL] Thank you for that information, [PII], and you're just wanting to verify the eligibility date?
[CUSTOMER][POSITIVE] Yes, and I me his benefits.
[AGENT][NEUTRAL] OK, so for what type of benefit is it an office or outpatient facility?
[CUSTOMER][NEUTRAL] Outpatient for Delta, are you able to share his group number with me please?
[AGENT][NEUTRAL] I can. I need to confirm the type of benefit. Did you say this is in a hospital or a doctor's office?
[CUSTOMER][NEUTRAL] It's a doctor's office. It's for dental service.
[AGENT][NEUTRAL] Doctor
[AGENT][NEUTRAL] Oh, it's dental.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Uh, the group number is 70056.
[CUSTOMER][NEUTRAL] 70056. OK, let me see if I pull it up right quick. Give me one second.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, and the group name? is it Man, analyze, utilization?
[AGENT][NEUTRAL] Uh, management analysis and utilization.
[CUSTOMER][NEUTRAL] OK, that's what I have it. OK, give me one second and um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The affected date?
[AGENT][NEUTRAL] So the policy effective date is [PII]. It is active at this time. Do you want the schedule of benefits faxed over to you, [PII]?
[CUSTOMER][POSITIVE] Oh yes ma'am, that would be so wonderful thank you so much.
[AGENT][NEUTRAL] You're welcome and what is that number?
[CUSTOMER][NEUTRAL] 6782477952
[AGENT][NEUTRAL] OK, so that's [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, give me just a moment.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][POSITIVE] OK, so you should be receiving the schedule within the next 5 to 7 minutes. I have sent it over to you.
[AGENT][NEUTRAL] And on the schedule of benefits will be the calendar year maximum information and deductible amounts, um, preventive and basic is listed those are the only categories that are covered major is noncovered.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it'll provide the frequencies, the common limitations, exclusions, the payer ID number, mailing address, and fax number, and it'll list each procedure code that's covered under the patient's policy. So it's gonna be about 5 pages including the um cover page.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, I
[CUSTOMER][POSITIVE] OK, I really appreciate it thank you so much.
[AGENT][POSITIVE] Oh, you're welcome, [PII]. If no other questions, thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Uh huh bye bye.