AccountId: 011433970860
ContactId: a4895e20-6356-4f5b-bc11-2b5b9e444901
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 199860 ms
Total Talk Time (AGENT): 100276 ms
Total Talk Time (CUSTOMER): 67916 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/a4895e20-6356-4f5b-bc11-2b5b9e444901_20250513T18:36_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good afternoon Mrs. [PII]. I was calling to get benefit information on a patient we have here in the office.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the benefits. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] My name is [PII] and the phone number is gonna be [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] It's gonna be 02612674.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Mr. [PII] [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment.
[CUSTOMER][NEUTRAL] You know
[AGENT][NEUTRAL] I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And did you have particular questions about the fax back or did you need a copy of it?
[CUSTOMER][POSITIVE] Well if you could um fax it over to me, that'd be great.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so on the fax back you'll see the calendar year maximum deductible, all the um frequencies, percentages, all the ways to file a claim, exclusions, and then there's a list of covered codes. If the code you're looking for is not on this list, it wouldn't be covered by the policy.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK, and like missing two clauses and downgrades they're on there too?
[AGENT][NEUTRAL] Yes, they are all exclusions. They'll be under exclusions, but there is a missing tooth cloth on here and
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on, I'm trying to check the history for you.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] And so far we don't have any history on file for the patient. Um, what's a good fax number for you?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And should I put attention [PII]?
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[AGENT][NEUTRAL] OK, and it was [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] All right, well, I'll go ahead and send this over to you now. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Um, I just wanted to ask how many quads can be done in a day for SRP?
[AGENT][NEUTRAL] Oh, there's no specification.
[CUSTOMER][NEUTRAL] In and
[CUSTOMER][NEUTRAL] OK and then is there a group name for this policy?
[AGENT][NEUTRAL] Yes, the group name, sorry, is Management Analysis and Utilization.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Or you can put MAU.
[CUSTOMER][POSITIVE] Got it thank you so much for your help today.
[AGENT][NEUTRAL] Did you need the number?
[AGENT][POSITIVE] Oh, you're welcome.
[CUSTOMER][NEUTRAL] I have the group number on here actually.
[AGENT][NEUTRAL] Got it. OK. Was there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No, ma'am, that's gonna be it.
[AGENT][POSITIVE] Alright, well, thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.