AccountId: 011433970860
ContactId: ea26d6d1-9d68-4c75-8de0-0720c2f13f1e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 143699 ms
Total Talk Time (AGENT): 67050 ms
Total Talk Time (CUSTOMER): 57423 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/ea26d6d1-9d68-4c75-8de0-0720c2f13f1e_20250124T13:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, uh, my name is [PII], and I'm calling to get um some eligibility information for a patient.
[AGENT][NEUTRAL] OK, when you say eligibility, you mean the effective date of the policy is active?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, yes, and if the providers in or out of network.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what's the policy number?
[CUSTOMER][NEUTRAL] OK, it's 02451064.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected [PII]?
[CUSTOMER][NEUTRAL] Of course, it's [PII].
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, so I have your requested information eligibility and then whether uh this office is or in network. Uh the the policy effective date is [PII]. Policy is active and the network of contracted providers is Carrington.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, we do not have a list of their providers, but are you familiar with that network?
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] Mhm, yes ma'am, we are.
[AGENT][NEUTRAL] OK, alright, and did you have any other questions?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Yes, um, since we are in network, may I have the group name and the max annual amount?
[AGENT][NEUTRAL] Uh, the calendar year max is $500 and I'm showing the group name. This information I believe is also on the patient's ID card. It's ATC Healthcare Services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and then, um, one last question, what percent of Endo is covered?
[AGENT][NEUTRAL] Major is not covered. This policy covers basic and preventive only.
[CUSTOMER][NEUTRAL] OK perfect and may I have your name please?
[AGENT][NEUTRAL] Mhm. You'll use my name in today's date is your reference, [PII]. Any other questions?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, Ms. [PII], thank you so much for your help. I really appreciate it.
[AGENT][POSITIVE] Oh, you're welcome. Thanks for calling APL [PII] have a good day.
[CUSTOMER][POSITIVE] You too OK bye bye.