AccountId: 011433970860
ContactId: cfabeeee-d98a-42fc-a993-f1a49445cc50
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 170839 ms
Total Talk Time (AGENT): 87949 ms
Total Talk Time (CUSTOMER): 64528 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/cfabeeee-d98a-42fc-a993-f1a49445cc50_20250415T12:38_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] with Dr. [PII]'s office, and I was checking eligibility and benefits for a patient.
[AGENT][POSITIVE] OK, well I can help you.
[CUSTOMER][NEUTRAL] Now is this a OK I'm sorry, go ahead, OK.
[AGENT][NEUTRAL] It's OK. Um, I can help you with both the eligibility and the benefits, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you for that and then um you had a question?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I, I completely lost it. I'm sorry, um.
[AGENT][NEUTRAL] Oh, it's OK.
[CUSTOMER][NEUTRAL] I, well, I, I guess I need to know if this is an HMO plan or a PPO plan. I'm sorry, my mouth early in the morning my mind's whirling, but she, this girl brought the card in and I'm not familiar with the insurance at all, so I didn't know if you do fax backs or I just, I just need a rundown of her benefits.
[AGENT][NEUTRAL] OK. Um, may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, 02556897.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active, it's been effective since [PII]. Um, this policy is on the Carrington PPO network. However, if you all are not a Carrington provider, um, the benefits are still the same.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, there is a copy of the fax back that I can send to you. It will have the calendar year maximum deductible, all the percentages, frequencies, the ways to file a claim, and then there's a list of covered codes on the fax back. If the codes you're looking for aren't on the fax back, it wouldn't be covered by the policy.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, OK, that's perfect I appreciate it.
[AGENT][NEUTRAL] You're welcome. And um what I I just checked the um policy to see if there was any history also, but I don't, there's none here yet.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] All right, what's a good fax number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And should I put attention, [PII]?
[CUSTOMER][NEUTRAL] That'd be fine.
[AGENT][NEUTRAL] OK, and it was [PII]?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] All right, well, I am sending this over to you now, [PII]. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, you've been very helpful I appreciate it thank you.
[AGENT][POSITIVE] You're welcome. I'm glad I could assist you. Thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] You also thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] You