AccountId: 011433970860
ContactId: 7ac8f7cf-edf6-4bd4-9248-c682572c222c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258470 ms
Total Talk Time (AGENT): 97078 ms
Total Talk Time (CUSTOMER): 124086 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/7ac8f7cf-edf6-4bd4-9248-c682572c222c_20250605T21:49_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, I'm just calling to um we just have a patient that came in and I'm just calling to see if she is eligible and get a breakdown um I'm just not able to pull her up online.
[AGENT][NEUTRAL] OK, I can verify eligibility and benefits for you and your name is?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, yeah, on our online service center as far as providers, uh, you'll only be able to verify claim status, not benefits. So, but, uh, Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is 02637456.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah it's [PII] 0 I'm sorry I'm giving you my cell phone number.
[CUSTOMER][NEUTRAL] Let's start over. It's, do you ever wonder like how many times you do that and don't realize it.
[AGENT][NEUTRAL] Oh, I've done it and I gave a fax number, gave my cell number, and I was wondering why I kept having that buzzing sound, but go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I know I'm like why don't you just personally call me? It's [PII].
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] [PII] OK and Ms. [PII] verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] OK, it looks like your policy just became effective [PII] of this year, and what's your fax number? I can send you a fax back.
[CUSTOMER][POSITIVE] OK, yeah, that would be great it's [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, so [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, I will send this off to you in a few moments. Is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um, just while I have you on there in case, I've never done this insurance breakdown. Do you have a missing tooth cloth?
[AGENT][NEGATIVE] Uh, there is a missing tooth cloth.
[CUSTOMER][NEUTRAL] Yes, and then waiting periods.
[AGENT][NEUTRAL] Uh, there's no waiting period.
[CUSTOMER][NEUTRAL] OK, and then on posterior composites do you downgrade?
[AGENT][POSITIVE] Uh, there are no downgrades.
[CUSTOMER][NEUTRAL] No downgrade and then I'm sure everything else will be on.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] That's breakdown.
[AGENT][NEUTRAL] Uh, yes, ma'am.
[CUSTOMER][NEUTRAL] So OK
[CUSTOMER][NEUTRAL] All right, I will just wait for that to come through.
[AGENT][POSITIVE] Alright, I will send this to you in a few moments. Um, is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You know what, just in case our email has been sketchy, she even emailed me her.
[CUSTOMER][NEGATIVE] Card and it still hasn't come through what is like the preventative um.
[CUSTOMER][NEUTRAL] The percentage for preventative and basic.
[AGENT][NEUTRAL] Uh, preventative is 100% of UCR Basic is 80.
[CUSTOMER][NEUTRAL] OK, and then bye wings, how many frequencies?
[AGENT][NEUTRAL] Uh, by weights are 1 for 12 month period.
[CUSTOMER][NEUTRAL] And what about exams? Um, I can get you a code too if you want.
[AGENT][NEUTRAL] Well, all exams share the same frequency of 2 for 12 month period.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, I that will get me to what I need to so I get that back.
[AGENT][NEUTRAL] OK, uh, and also on the fax back it does have our, uh, mailing address, fax number, and payer ID.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, perfect. Oh, you know what, what is your fee schedule? Are you guys under [PII]? I did see that on her card.
[AGENT][NEUTRAL] No, ma'am, uh, this one doesn't pay by a fee schedule pays by UCR.
[CUSTOMER][NEUTRAL] Do you know what your fee schedule would be?
[CUSTOMER][NEUTRAL] UCR
[CUSTOMER][NEUTRAL] OK, um, OK, alright, I'll wait for that fax back thank you.
[AGENT][POSITIVE] Uh, yes, ma'am. Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too.