AccountId: 011433970860
ContactId: e3d29d73-e350-4fde-97e9-de154a43b29b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 237970 ms
Total Talk Time (AGENT): 131316 ms
Total Talk Time (CUSTOMER): 58235 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/e3d29d73-e350-4fde-97e9-de154a43b29b_20250305T17:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, my name is [PII]. I'm calling from Hammon andhoonics. I'm trying to get eligibility and benefits of a patient.
[AGENT][NEUTRAL] Sure, I can take eligibility and benefits for you. You said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] 613-606
[AGENT][NEUTRAL] OK, and then, uh, what was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that [PII]. So this policy is active. Effective date was [PII], and if you'd like I can send you a fax back that shows all of the covered procedures and benefit information.
[CUSTOMER][POSITIVE] Yes, yes, that would be great.
[AGENT][NEUTRAL] OK, uh, what was that fax number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and I'll just put this to your attention, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Alrighty, I will get that sent to you. Should get it here within 10-15 minutes. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Yes, what's the patient's annual max?
[AGENT][NEUTRAL] Yes, one moment, let me get that information for you.
[AGENT][NEUTRAL] And of course I will let you know verification of coverage is not a guarantee of payment for claims. Uh, their calendar year maximum is $1000 deductible is $50 per calendar year, and that does not apply to exams.
[CUSTOMER][NEUTRAL] Has anything been used or met?
[AGENT][NEUTRAL] Let me check that, one moment.
[AGENT][NEUTRAL] No, none has been used so far this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Any waiting periods on basic and major?
[AGENT][NEUTRAL] Let's see, uh, no waiting periods.
[CUSTOMER][NEUTRAL] OK, and I have some quotes. Can you tell me if you guys cover this?
[AGENT][NEUTRAL] Oh, sure, go ahead.
[CUSTOMER][NEUTRAL] 3310.
[AGENT][NEUTRAL] 3310, 0, I'm sorry.
[CUSTOMER][NEUTRAL] 33
[CUSTOMER][NEUTRAL] You want all at once or one at a time?
[AGENT][NEUTRAL] Whatever is easier for you is fine.
[CUSTOMER][NEUTRAL] I'm gonna do them all at once. 3310.
[AGENT][NEUTRAL] Sure. Uh-huh.
[CUSTOMER][NEUTRAL] 3320
[CUSTOMER][NEUTRAL] 3330.
[CUSTOMER][NEUTRAL] 33 46 33 47 and 3348.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and so as this plan is not a part of um any sort of network, it simply pays a set dollar amount per covered procedure.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So $3310 is that benefit amount is uh $202.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 3320.
[AGENT][NEUTRAL] Is covered at $319.
[CUSTOMER][NEUTRAL] That's for 3320.
[AGENT][POSITIVE] Oh, I'm sorry, that was 3330. I am so sorry um sorry about that. $3320 is covered at $247.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Then
[AGENT][NEUTRAL] 3346 is not a covered benefit.
[AGENT][NEUTRAL] Neither is 3347.
[AGENT][NEUTRAL] And neither is 3348.
[CUSTOMER][NEUTRAL] Alright, and can I get a reference number for this call?
[AGENT][NEUTRAL] Sure, it would just be my first name, last initial and today's date. Uh, so my name is spelled [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] Alright, well thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Right.