AccountId: 011433970860
ContactId: 803f1fff-e2b1-468f-9240-989e420f4ccb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209380 ms
Total Talk Time (AGENT): 97885 ms
Total Talk Time (CUSTOMER): 67241 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/803f1fff-e2b1-468f-9240-989e420f4ccb_20250226T21:32_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh, hi, this is [PII] calling from Marketent provider's office. I need to verify the patient's eligibility and benefit details. Could you assist me regarding this?
[AGENT][POSITIVE] Uh, yes, I can verify benefits for you, and I apologize, your name is again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] I can see that the policy number of this patient is.
[CUSTOMER][NEUTRAL] 614-132.
[AGENT][POSITIVE] OK, thank you so much. Give me one moment, please. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, I can see that the callback number is [PII] and the rendering extension is 3007.
[AGENT][NEUTRAL] OK, and thank you and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Patient's first name is [PII] is the first name and the last name is [PII] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And you say you're calling to verify benefits and eligibility, correct?
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][NEUTRAL] OK, I'm showing an effective date of [PII], I'm sorry, [PII] policy is active.
[AGENT][NEUTRAL] And are you just need a general breakdown or I can send you a fax back?
[CUSTOMER][NEUTRAL] Uh, I have some, I have some specific benefits if you don't mind, could you assist me with the deductibles and annual max participation plan?
[AGENT][NEUTRAL] Uh, not a guarantee of payment, just a verification of coverage. The patient has a benefit max up to $1000 per calendar year, and they have a $50 deductible that is applied to everything but the exam and profy.
[CUSTOMER][NEUTRAL] Can I get the co insurance percentage for preventative basic measure?
[AGENT][NEUTRAL] Uh, the policy doesn't pay by a percentage, uh, doesn't pay by UCR, it pays by their policy fee schedule.
[CUSTOMER][NEUTRAL] OK, is there any group name or group number?
[AGENT][NEUTRAL] Uh, no, sir.
[CUSTOMER][NEUTRAL] OK, once again I need to confirm is the patient is a policy holder for this plan, right?
[AGENT][NEUTRAL] They are, yes.
[CUSTOMER][NEUTRAL] OK, and could you go with once again with an effective date?
[AGENT][NEUTRAL] Uh, 7, wait, hold on.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Uh, yes.
[CUSTOMER][NEUTRAL] OK, is there any history of participation policy which affects the frequency or is there a history for this year?
[AGENT][NEUTRAL] Uh, let me see one moment.
[AGENT][NEUTRAL] Uh, sure, the last cleaning and exam, uh, was on [PII].
[AGENT][NEUTRAL] And give me a moment.
[CUSTOMER][NEUTRAL] Is there any history for FMX and panel?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Last peo was [PII].
[AGENT][NEUTRAL] Last FM FMX I don't show any history of an FMX.
[CUSTOMER][NEUTRAL] OK, could you go with the name and call reference number?
[AGENT][NEUTRAL] Uh, my name is [PII], last initial [PII] Uh we don't give call reference numbers, however, if you like, you may use my name at today's date.
[CUSTOMER][POSITIVE] Thank you, [PII]. Thank you for providing valuable information. Have a nice day.
[AGENT][POSITIVE] Oh, you too, [PII], and thank you for calling APL.