AccountId: 011433970860
ContactId: d551a1c6-0161-402c-97c2-932941732339
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 300179 ms
Total Talk Time (AGENT): 107477 ms
Total Talk Time (CUSTOMER): 87264 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/d551a1c6-0161-402c-97c2-932941732339_20250327T15:34_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] Hey, good morning, [PII]. My name is [PII].
[CUSTOMER][NEUTRAL] And I was going to get a benefit breakdown for a patient, please.
[AGENT][POSITIVE] All right. Well, I'll be more than happy to help you with the benefits. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] no extension.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Mm, OK, yeah, let's check if he's on the policy 02607909.
[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] Mm, uh, [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment and
[AGENT][NEUTRAL] Did you need a copy of the fax back or you have particular questions about it? Let me pull it. Hold on one second.
[CUSTOMER][NEUTRAL] Well, I have called already um another day, um, and I got the benefit breakdown, but I wanted to get the mailing or the PO box mailing address for claims.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so that's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] My zip my zip code, our zip code is [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Thank you. It technically is your zip code, right? Are you, do you live there?
[AGENT][NEUTRAL] Right. Well, no, no, I'm in [PII].
[CUSTOMER][NEUTRAL] Oh, OK, OK, um.
[CUSTOMER][NEUTRAL] Yeah, let me, uh, ask you, is her husband [PII] on the policy?
[AGENT][NEUTRAL] Yes, hold on one moment. Let me go back to that.
[AGENT][NEUTRAL] Yes, he's the um the active spouse on the policy. Mhm.
[CUSTOMER][POSITIVE] Awesome and it's the same coverage for him?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And is there any history for him?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Um, no, as of now, we have not processed any claims for him, for either.
[CUSTOMER][NEUTRAL] And his
[CUSTOMER][NEUTRAL] OK, and his, um, amount yearly amount is also the 500?
[AGENT][NEUTRAL] I just uh hold on one second, let me go back to the
[AGENT][NEUTRAL] Yes, the calendar year max is 500 per insured.
[CUSTOMER][NEUTRAL] And the $50 deductible as well, correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And let me ask you, is our doctor in network with your, with your policy, with this policy, I mean?
[AGENT][NEUTRAL] So the policy is um Carrington PPO. However, if your provider is not a Carrington provider, um, they just won't receive the additional uh percentage, the benefits are the same. I can give you the number to Carrington if you'd like to see if your providers in network. We just don't have access to their list.
[CUSTOMER][NEUTRAL] OK, if you don't mind please.
[AGENT][NEUTRAL] Sure, hold on one moment.
[AGENT][NEUTRAL] And that's 800.
[AGENT][NEUTRAL] 290.
[AGENT][NEUTRAL] 0523.
[CUSTOMER][POSITIVE] Um, awesome.
[CUSTOMER][NEUTRAL] OK, well thank you very much, [PII]. Can I please have a reference number for this call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK, and then before I let you go, the payer ID number is 0801.
[AGENT][NEUTRAL] Um, 60801.
[CUSTOMER][NEUTRAL] So 608.
[CUSTOMER][NEUTRAL] 01.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Awesome. OK, thank you so much for your time you have a great day.
[AGENT][POSITIVE] You also, was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that would be it. Thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] No