AccountId: 011433970860
ContactId: c8d5b765-506e-4635-ac90-9408db8786d3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 318609 ms
Total Talk Time (AGENT): 133938 ms
Total Talk Time (CUSTOMER): 84356 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/2025/01/17/c8d5b765-506e-4635-ac90-9408db8786d3_20250117T21:07_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] She
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling from a provider's office.
[AGENT][POSITIVE] Yes ma'am. How are you today?
[CUSTOMER][POSITIVE] I'm good and you?
[AGENT][POSITIVE] I'm fine, thank you. I'm glad it's Friday, [PII].
[CUSTOMER][NEUTRAL] Yes, me too.
[AGENT][POSITIVE] Well, how can I help you today?
[CUSTOMER][NEUTRAL] I'm calling to verify um a patient insurance and benefits eligibility.
[AGENT][NEUTRAL] OK, so you need eligibility and benefits for a member, is that correct? Yes, ma'am, I can help you with that with that information. And what is your callback number, please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, I have one.
[CUSTOMER][NEUTRAL] Right behind the bridge.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I think it was
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] 02543866
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I thought that I was not gonna have to worry about.
[CUSTOMER][NEUTRAL] Be
[AGENT][NEUTRAL] OK. And what type of policy is this that you're calling on, [PII]?
[CUSTOMER][NEUTRAL] Um, we're dental.
[AGENT][NEUTRAL] OK, so for our dental policies, I will send you a fax back of the member's benefits. Give me just a moment while their policy information is still loading.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that's the ones that doctors treat uh like.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] That's the only way
[CUSTOMER][NEUTRAL] Send it to
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on this general plan and this policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Give me a second.
[AGENT][NEUTRAL] And give me a moment, please, to get his fax that pulled up and I will send that to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And will the facts need to be put to your attention, [PII], or is that not necessary?
[CUSTOMER][NEUTRAL] That's not necessary.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and what is a good fax number that I can send this to?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and I'm just gonna repeat that to make sure I heard it correctly. [PII].
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, so I have just sent that to you and you should be receiving that within the next several minutes. [PII], anything that is not on that fax back means it would not be covered under his policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Also, um, once the claim has been processed with APL, we do have a portal in which you should be able to check claim status and also have access to the explanation of benefits.
[AGENT][NEUTRAL] And our portal website that you would register on is secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEGATIVE] And there is no history on file for him.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let
[AGENT][NEUTRAL] And is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] OK, well then thank you very much for calling APO and I hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] Thank you, same to you.
[AGENT][POSITIVE] Yes, ma'am. Thank you.
[CUSTOMER][NEUTRAL] Alright bye.
[AGENT][NEUTRAL] Bye.