AccountId: 011433970860
ContactId: 76c1a24c-fe19-4598-83a5-0de3064ca67d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 302829 ms
Total Talk Time (AGENT): 142351 ms
Total Talk Time (CUSTOMER): 67555 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/76c1a24c-fe19-4598-83a5-0de3064ca67d_20250224T19:04_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I have a patient that I'm needing to verify benefits with, um, I just wanna make sure that we are in network with this plan.
[AGENT][NEUTRAL] OK, so you have a question regarding benefits and also network, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am, I can help you with part of that, and whom am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] Um, 02579739.
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, is this for dental, [PII]?
[CUSTOMER][NEUTRAL] Yeah yes.
[AGENT][NEUTRAL] And on our dental policies, [PII], if you need benefits on this memoir, we do have facts facts of the benefits that I'll be happy to send to you, and anything that is not on the fact that means it would not be covered by his plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so first off, and any information that I do provide would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And his birthday is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on this general plan, [PII], and it is active with an effective date of [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this plan that he is um enrolled for is not a network plan.
[AGENT][NEUTRAL] He may select any provider. It's a non-network plan.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] OK, so it's like a PPO?
[AGENT][NEUTRAL] No, the covered services are based on a percentage of the UCR of the service region. Again, it's not a network.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what is a good fax number, [PII], that I can send his benefits to?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and does it need to be put to your attention, [PII], or is that not necessary?
[CUSTOMER][NEUTRAL] Um, you can put it to my attention.
[AGENT][NEUTRAL] Yes, put it to your attention. OK, just one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and I'm just gonna repeat the fact back to you to make sure I heard you correctly. [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] All right, so that has just been sent to you so it provided there's not any type of technical mishap, you should be receiving that within just the next few minutes.
[CUSTOMER][NEUTRAL] Alrighty and then you did say that this is based off of uh UCR schedule?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] This is based on correct, a percentage of the UCR of the service region.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am, and that information is also on that fax back.
[AGENT][NEUTRAL] It states that on the fact that.
[CUSTOMER][POSITIVE] Yes ma'am, thank you so much.
[AGENT][POSITIVE] Oh, you are certainly very welcome. So again, is there anything else I can help you with today, [PII]?
[CUSTOMER][POSITIVE] No, ma'am, you've been wonderful.
[AGENT][POSITIVE] Oh, well, it was my pleasure in helping you today. So thank you for saying that. That was very kind. So, um, if that is all I can help you with, thank you again for calling APO and I hope you have a great afternoon.
[CUSTOMER][NEUTRAL] Alright you as well.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.