AccountId: 011433970860
ContactId: d4e6cc6a-ba98-4888-8b1e-56abfc663bc0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305940 ms
Total Talk Time (AGENT): 102745 ms
Total Talk Time (CUSTOMER): 94865 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/d4e6cc6a-ba98-4888-8b1e-56abfc663bc0_20250116T22:37_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I need to um verify eligibility and benefits for a patient.
[AGENT][NEUTRAL] OK, I'm happy to check on benefits and eligibility. what is their policy number?
[CUSTOMER][NEUTRAL] Um, 617-750.
[AGENT][NEUTRAL] All right. Let me pull that up here. One moment.
[AGENT][NEUTRAL] And can I get the uh patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you so much. So patient plan is active. The effective date is [PII], and if you guys need, we can also send a fax back with benefits.
[CUSTOMER][NEUTRAL] OK, has anything changed on the plan starting like [PII]?
[AGENT][NEUTRAL] Uh, OK.
[CUSTOMER][NEUTRAL] Or is it all still the same? I have a breakdown. I just need to know if there's any like changes or.
[AGENT][NEUTRAL] Yeah, it looks like it's all the same. Nothing has changed.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] And what is um the remaining benefits like is he used anything?
[AGENT][NEUTRAL] Yeah, let me take a look here one second.
[CUSTOMER][NEUTRAL] And then like I would just need like preventative history like the most recent.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] Alright, looks like the patient has full amount left for the year. So it looks like it's a $1000 calendar year maximum and the deductible is still remaining.
[CUSTOMER][NEUTRAL] See you there
[AGENT][NEUTRAL] Let me see history.
[AGENT][NEUTRAL] Last cleaning that I see on file for IV was on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And then for like FMX Peno let's see I have [PII] of 23, is that what you have?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, um, and while I have you on the phone and already pulled up this account, can we go ahead and check Ms. [PII] as well?
[AGENT][POSITIVE] Yeah, absolutely, let's see.
[CUSTOMER][NEUTRAL] And I just basically need the same information her um remaining in history.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like a full amount remaining for the calendar year for [PII] that would be for the uh deductible and the calendar year max.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Looks like the last cleaning I show on file service date was [PII].
[CUSTOMER][NEUTRAL] And then for
[AGENT][NEUTRAL] Full mouth X-rays.
[CUSTOMER][NEUTRAL] Do you have any yeah.
[AGENT][NEUTRAL] Yeah, it looks like the last I see is on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Was there anything else I can check on?
[CUSTOMER][NEUTRAL] And then um just one more question regarding this plan um.
[CUSTOMER][NEUTRAL] 0431 is that a payable code?
[AGENT][NEUTRAL] 0431.
[AGENT][NEGATIVE] I'm not seeing it on the fax facts, so that would mean that it's not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Just wanted to double check on that sometimes it changes.
[AGENT][POSITIVE] No. Yeah, no problem.
[CUSTOMER][POSITIVE] All right, that's all I need thank you.
[AGENT][POSITIVE] You're welcome. Have a good rest of your day.
[CUSTOMER][NEUTRAL] Alright you too bye bye.
[AGENT][NEUTRAL] Bye bye.