AccountId: 011433970860
ContactId: a1e62998-8a9f-48a7-8763-0beae44b6717
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 233720 ms
Total Talk Time (AGENT): 96825 ms
Total Talk Time (CUSTOMER): 143918 ms
Interruptions: 5
Overall Sentiment: AGENT=1.5, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/a1e62998-8a9f-48a7-8763-0beae44b6717_20250213T17:34_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm trying to get benefits for dependent or see that they're still active.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Um, [PII], and you said the policy number?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 023-268-885.
[AGENT][NEUTRAL] Thank you, [PII]. Could you verify the patient's name and date of birth that you're inquiring eligibility for today?
[CUSTOMER][NEUTRAL] Um, [PII] [PII].
[AGENT][NEUTRAL] Um, we have a different date of birth. Could you verify to make sure that her date of birth is correct?
[CUSTOMER][NEUTRAL] Let me look at the paperwork they filled out, see.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, the paperwork they filled out says 1016 20.
[AGENT][NEUTRAL] Oh, so you gave me [PII], but you just said 1016. So 1016 is correct. So Ariel is covered under the policy and she has been since October.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The [PII] and well I'm sorry, [PII] and it's currently active.
[CUSTOMER][NEUTRAL] OK, um, can you fax that over to me? Um, uh, let me see if I had a question.
[AGENT][NEUTRAL] Of course. Provide me with the spelling of your name and the fax number.
[CUSTOMER][NEUTRAL] Uh, [PII] and then [PII] um.
[CUSTOMER][NEUTRAL] So if the codes are not in, it doesn't have any codes in there. If the code's not in there doesn't mean it's, it means it's not covered, right?
[AGENT][NEUTRAL] Yes, that is correct. So the codes have not been updated since the update, but if it fits the description of the new code, then that means that it's covered. Like on the schedule, it should have a description of each procedure code and if it fits that description, then it becomes so basically if you guys submit a claim here with us with the new codes, then the system will automatically change the codes to the old codes for the the system to pay it.
[CUSTOMER][NEUTRAL] OK, just
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm, because I'm looking at the old fax and I was looking at the [PII], even the ceilings, I don't even see that on there. I don't know if the fax cut it off because there's like a weird line in it.
[AGENT][NEUTRAL] Um, on page.
[CUSTOMER][NEUTRAL] Does it show a 1351 off some page um 3 from the last fax that I got from y'all.
[AGENT][NEUTRAL] Hold on, let me look.
[AGENT][NEUTRAL] Let me pull it up.
[CUSTOMER][NEUTRAL] Because I was trying to see if the ceilings were covered in um 1351 and 1354.
[AGENT][NEUTRAL] Cause this should fall under the category of preventative.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Do you see the preventative category?
[CUSTOMER][NEGATIVE] Mm yeah that's what I'm on there but it's what I'm saying, but it's like cut off.
[AGENT][NEUTRAL] On the 2nd page.
[CUSTOMER][NEUTRAL] Um, yeah, but it's cut off when I, when I'm on the paper, like there's like a line and it doesn't show the code like it shows 120 I think it's showing the 1208 and then it cuts off and it goes to space maintainer so it's not showing the sealants if it's on there.
[AGENT][NEUTRAL] The 1351 is covered.
[CUSTOMER][NEUTRAL] Mhm, is it 1354 on there?
[AGENT][NEUTRAL] On the preventative. 1351.
[CUSTOMER][NEUTRAL] OK, OK, um, yeah, I'll just get a fax for that then.
[AGENT][NEUTRAL] So I can send you a copy of this.
[CUSTOMER][NEUTRAL] Uh, I made him like but you guys.
[AGENT][POSITIVE] All right, so I'm gonna send you a copy of it. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] So not that
[CUSTOMER][NEUTRAL] Um, no, that was it.
[AGENT][POSITIVE] Alright, well, [PII], it was a pleasure speaking with you. Thanks for calling APL and you have a great day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thanks, bye.