AccountId: 011433970860
ContactId: e340c842-748a-44e8-8399-248fe6d3b1fe
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 183279 ms
Total Talk Time (AGENT): 101647 ms
Total Talk Time (CUSTOMER): 49728 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=2.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/e340c842-748a-44e8-8399-248fe6d3b1fe_20250103T14:38_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], I'm actually just calling for benefits and eligibility for a patient.
[AGENT][NEUTRAL] OK, well, I can help you with both the benefits and the eligibility. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, 02554118.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And [PII], can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII], [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].
[AGENT][NEUTRAL] And let me see what type of policy they have. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And did you need a copy of the fax back or you have particular questions?
[CUSTOMER][POSITIVE] Yeah, a copy of the fax back would be great.
[AGENT][NEUTRAL] OK, let me see, uh, it's coming up now, hold on.
[CUSTOMER][NEUTRAL] As long and then let me know if it has max and deductible and all that on there and what's been met.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] I'm just waiting for everything to come up here, sorry about that.
[CUSTOMER][NEUTRAL] No rush, you're fine.
[AGENT][NEUTRAL] OK, so the calendar year max and deductible are on the fax back all the percentages, frequencies, exclusions, the three ways to file a claim, and then there's a list of codes on here.
[AGENT][NEUTRAL] If the code you're looking for is not on this list, then it wouldn't be covered by the policy, um, but I just checked to see because it's a calendar year, so they haven't used anything for [PII] yet.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][NEUTRAL] OK, and then one last question, any waiting periods?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, um, this policy doesn't cover major. Major for us includes endodontic, periodontic, prosodontic, and oral surgery.
[CUSTOMER][NEUTRAL] OK, so, um, no coverage for those correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And then what's a good fax number for you can for me to send this to you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] So [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] And do I need to put attention, [PII]?
[CUSTOMER][POSITIVE] Yeah, that'd be great.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I am faxing this to you right now. Was there anything else I can help you with today, [PII]?
[CUSTOMER][POSITIVE] That's it. Thank you so much.
[AGENT][POSITIVE] You're welcome. Well, thanks so much for calling APL and happy New Year and I hope you have a great weekend.
[CUSTOMER][POSITIVE] Happy new year to you take care.
[AGENT][POSITIVE] Thank you. You also. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.