AccountId: 011433970860
ContactId: 801595e2-46d7-4379-9c54-d15e629cbb8e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 293299 ms
Total Talk Time (AGENT): 135730 ms
Total Talk Time (CUSTOMER): 111249 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/801595e2-46d7-4379-9c54-d15e629cbb8e_20250501T18:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] and I am calling from Cascade and Oonics in [PII], and I just need help getting some benefit information on a member's plan apnea.
[AGENT][POSITIVE] All right, [PII], I'm happy to check on benefits. Do we have a policy number?
[CUSTOMER][NEUTRAL] I do, yeah, it is.
[CUSTOMER][NEUTRAL] 01753470
[AGENT][POSITIVE] OK, thank you so much. Let me pull this up.
[CUSTOMER][POSITIVE] Thank you for calling and.
[CUSTOMER][NEUTRAL] How can I help you?
[AGENT][NEUTRAL] All right. And then if I could get the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It is for [PII]. Birthday is [PII].
[AGENT][NEUTRAL] Alright, [PII], let me read this back to you. I copied down 0175.
[CUSTOMER][NEUTRAL] We could do Tuesday.
[CUSTOMER][NEUTRAL] I have a.
[CUSTOMER][NEUTRAL] 30 or 9?
[AGENT][NEUTRAL] 3470.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, that doesn't come up with that name. Um, you said the last name is [PII]?
[CUSTOMER][POSITIVE] Yeah, you're welcome.
[CUSTOMER][NEUTRAL] Yeah, [PII]
[AGENT][NEUTRAL] OK, and then the first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. So it looks like the patient's plan uh just does not have the one in the beginning. So it's 753-470.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][MIXED] OK, but the 01 is not at the beginning starts with number 7, OK.
[AGENT][NEUTRAL] Yes, ma'am. Yes, ma'am. Yeah. So that's we were just like a number off. Um, anyhow, patient is, patient is active, uh, effective date is [PII], it looks like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and so I guess I'm not familiar with with you guys, so I, I'm not even sure if my provider would be considered in or out of network. Is that something you can check? Is there a network?
[AGENT][NEUTRAL] Uh, so this particular policy does not require any sort of network. It pays on a fee schedule and so if you needed us to, we can send you a fax back with a complete breakdown.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah, that would be good. um, does his plan have like a yearly maximum deductible on it as well?
[AGENT][POSITIVE] Yes, ma'am. I'm happy to provide that to you.
[CUSTOMER][NEUTRAL] OK, yeah, if you could give me what his yearly max and deductible are and if he's met anything towards them.
[AGENT][NEUTRAL] Yeah, absolutely. OK, so yearly max is gonna be $1000.
[AGENT][NEUTRAL] And their calendar year deductible is $50.
[AGENT][NEUTRAL] And then let me see what they've used for the year.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] It looks like the deductible is um remaining or excuse me, the deductible has been used.
[AGENT][NEUTRAL] Out of the out of the $1000 the patient has used $129. That leaves the remaining balance at $871.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome and then is your guys' claim mailing address this [PII]? OK, yeah, if you could fax me over a fee schedule, that would be great.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Not a problem, [PII]. What's a good fact for you?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So just to confirm, I had [PII]?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] All right. So give it about 5 minutes and you should have that. Is there anything else I can check on?
[CUSTOMER][NEUTRAL] No, that was it. Can I just get a reference number on this phone call?
[AGENT][NEUTRAL] Absolutely. Call references my name with my last initial and then today's date. My name again is [PII], that's [PII] Last initial is [PII], and then today's date.
[CUSTOMER][POSITIVE] OK perfect thank you so much for your help.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too mm
[AGENT][NEUTRAL] Bye bye.