AccountId: 011433970860
ContactId: 6e26d1e3-d05a-440e-a040-bf4743fb90b4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 394149 ms
Total Talk Time (AGENT): 107049 ms
Total Talk Time (CUSTOMER): 111118 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/6e26d1e3-d05a-440e-a040-bf4743fb90b4_20250418T14:25_UTC.wav
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[AGENT][POSITIVE] Thank you for calling HTL. This is. How can I help you?
[CUSTOMER][NEUTRAL] Hey, this is [PII]. I'm calling from Greenville Oral Surgery. I'm just trying to verify patients benefits for um an upcoming appointment.
[AGENT][NEUTRAL] OK, [PII], I can help you with benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And the policy number of the patient?
[CUSTOMER][NEUTRAL] 247952401.
[CUSTOMER][NEUTRAL] And warming up outside.
[CUSTOMER][NEUTRAL] One
[AGENT][NEUTRAL] Extra number. What was that policy number again?
[CUSTOMER][NEUTRAL] 247952401.
[AGENT][NEUTRAL] So usually 8 digits, um, it's got 9.
[AGENT][NEUTRAL] Uh, do you have the name of the patient?
[CUSTOMER][NEUTRAL] Yeah, first name is um spell it [PII] and last name is [PII]
[AGENT][NEUTRAL] And what type of benefits were those for?
[CUSTOMER][NEUTRAL] Um, oral surgery.
[AGENT][NEUTRAL] OK, it looks like he gave me his social, that's what it was. OK, let me give you the policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect thank you.
[AGENT][NEUTRAL] OK, you said oral surgery, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Not a guarantee of payment, basic outline of the policy. Um, I can send a fax back, but I can also just check for the oral surgery.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, is it, uh, [PII] or?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] So I don't have those codes listed under the policy.
[AGENT][NEUTRAL] Just got [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So can I just assume that surgical extractions aren't covered?
[CUSTOMER][NEUTRAL] Of course
[AGENT][NEUTRAL] Yes, I don't show it covered under the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then um
[CUSTOMER][NEUTRAL] What's the effective date on the policy?
[AGENT][NEUTRAL] Effective [PII] and he's active.
[CUSTOMER][NEUTRAL] Is there a waiting period or anything?
[AGENT][NEUTRAL] Uh, no waiting period. Got a $500 calendar maximum.
[AGENT][NEGATIVE] And then prevented is 100%.
[AGENT][NEUTRAL] Basic is 80%, which includes radiographs and FMX, and then there's no major coverage.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Let me scan these. Let me work on that note if you wanna have a see there's about 5 or 6 pages there.
[CUSTOMER][NEUTRAL] Finished.
[CUSTOMER][NEUTRAL] Perfect and then what address did the claims for this go to?
[AGENT][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And does his policy cover like um.
[CUSTOMER][NEUTRAL] Like consultations and I think you said.
[CUSTOMER][NEUTRAL] It does cover like X-rays and things, right, because we'll have to take an X-ray when he's here. Is he eligible for those two benefits?
[AGENT][NEUTRAL] Um, let me see if he's used anything.
[AGENT][NEUTRAL] Yeah, I don't have any history for the years or for anything so far.
[AGENT][NEUTRAL] So X-rays pay 80.
[CUSTOMER][NEUTRAL] OK, and then you said.
[CUSTOMER][NEUTRAL] 80% OK.
[AGENT][NEUTRAL] Um, after $50 deductible.
[AGENT][NEUTRAL] And then exams and pro fees pay 100 100%.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Has he satisfied anything towards his deductible and max?
[AGENT][NEUTRAL] Uh, no, he's not. He doesn't have any claims on file.
[CUSTOMER][NEUTRAL] And then are, are we, um, can you check to see if we're in network with his plan?
[AGENT][NEUTRAL] Um, so they utilize Carrington. Um, I, I can't check that, um, I can give you the number for Carrington.
[AGENT][NEUTRAL] Do you need that number?
[CUSTOMER][NEUTRAL] No, that's OK. I'll just take can um can I just have your name and a reference number please?
[AGENT][NEUTRAL] Uh, my name is [PII], and first initial to last name, [PII], and then today's date.
[CUSTOMER][NEUTRAL] And do you need my fax number for that fax back?
[AGENT][NEUTRAL] Oh, yes, you need a fax back.
[CUSTOMER][POSITIVE] Please, yes ma'am.
[AGENT][NEUTRAL] What's your facts?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, give me just a few minutes and then I'll send that over.
[CUSTOMER][POSITIVE] Perfect thank you.
[AGENT][NEUTRAL] Like I feel.