AccountId: 011433970860
ContactId: d293a1ec-1ea0-47ee-92a6-8463596f9654
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 277799 ms
Total Talk Time (AGENT): 101669 ms
Total Talk Time (CUSTOMER): 61735 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/d293a1ec-1ea0-47ee-92a6-8463596f9654_20250305T15:30_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], um, this is [PII] at Palmetto and Doonics. I was just calling to get out of network benefits on a patient.
[AGENT][NEUTRAL] OK policy number.
[CUSTOMER][NEUTRAL] Um, I have 60801.
[CUSTOMER][NEUTRAL] I don't know if that's gonna be enough numbers for you, but.
[AGENT][NEUTRAL] That's the payer ID number sounds like it's gonna be the outpatient policy er number that begins with the.
[CUSTOMER][NEUTRAL] No, of course, yeah, it is, it is, isn't it?
[CUSTOMER][POSITIVE] OK, yep, they did not, um, provide that to us, so I will be calling back shortly thank you.
[AGENT][NEUTRAL] OK. Do you have a social or anything or spell the name for me?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Um, I have.
[CUSTOMER][NEUTRAL] I have mom's name. It's [PII].
[AGENT][POSITIVE] [PII]
[CUSTOMER][POSITIVE] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm, that's what I said.
[CUSTOMER][NEUTRAL] And then date of birth is [PII].
[AGENT][NEUTRAL] So is she
[AGENT][NEUTRAL] OK, is she the patient?
[CUSTOMER][NEUTRAL] No, she'll be a subscriber.
[AGENT][NEUTRAL] Who is the patient?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you. Give me one second, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Still looking.
[AGENT][NEUTRAL] And what state does [PII] reside?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And are you a medical or dental provider's office?
[CUSTOMER][NEUTRAL] Dental.
[AGENT][NEUTRAL] Dental, OK.
[AGENT][NEUTRAL] All right, so I do have the policy number if you want to make note of it. Let me know when you're ready.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] That number is 256.
[AGENT][NEUTRAL] 4042.
[AGENT][NEUTRAL] And [PII]'s, uh, the patient's date of birth, you gave me that. Her effective date is [PII]. I do show that the policy is active. And did you say that you wanted the benefits canal faxed over to you?
[CUSTOMER][NEUTRAL] Um, I, if I could just check, um, the maximum and deductible and then I have two procedure codes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the calendar year maximum is up to $500 per calendar year and the calendar year deductible is $50 per individual and then up to.
[AGENT][NEUTRAL] 150 for all combined persons that are covered under the policy.
[AGENT][NEUTRAL] And what were the two procedure codes?
[CUSTOMER][NEUTRAL] Uh, the first one is 9974 and the second one is 3310.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And did you say this was uh Pero?
[CUSTOMER][NEUTRAL] Uh, indo.
[AGENT][NEUTRAL] Endo, OK.
[AGENT][NEUTRAL] So this policy covers basic and preventive only major is not covered, so those codes are not covered under this particular policy.
[CUSTOMER][NEUTRAL] Alright, could I just grab a reference number from you?
[AGENT][NEUTRAL] Sure. You'll use my name in today's date as your reference. [PII]. It's spelled [PII], first initial and last name is [PII] in [PII], I mean, [PII], and any other questions?
[CUSTOMER][NEUTRAL] No ma'am, that'll be all.
[AGENT][POSITIVE] Alrighty, thanks for calling APL. Have a good day.
[CUSTOMER][POSITIVE] You too thank