AccountId: 011433970860
ContactId: ec42727d-1a92-4ac1-81fa-43c971aa7537
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316679 ms
Total Talk Time (AGENT): 145521 ms
Total Talk Time (CUSTOMER): 141204 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/ec42727d-1a92-4ac1-81fa-43c971aa7537_20250306T19:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm actually calling in regards to a patient. I am looking for eligibility and benefits.
[AGENT][NEUTRAL] Sure, I can check eligibility and benefits for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][POSITIVE] Absolutely it's going to be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, I do, um, so the policy number is going to be 197.
[CUSTOMER][NEUTRAL] 33
[CUSTOMER][NEUTRAL] 869.
[AGENT][NEUTRAL] OK, and then uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] So for the subscri I have the subscriber but I'm looking for the member, go ahead, I'm sorry.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Actually, I'm sorry [PII] really quick I don't mean to interrupt you um I think I might have misheard that policy number um could you repeat that for me?
[CUSTOMER][POSITIVE] No, you're good.
[CUSTOMER][NEUTRAL] Yeah, of course, um, I have it as 197.
[CUSTOMER][NEUTRAL] 33869.
[AGENT][NEUTRAL] OK, yeah, so that's gonna be one too many digits to be one of our policy numbers, yes, um, let me try it without, with one of the threes.
[CUSTOMER][NEGATIVE] One too many.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] Nope
[AGENT][NEUTRAL] Um, do you maybe have their social? I could search for them that way.
[CUSTOMER][NEUTRAL] Um, so it's not allowing me to see the social on the registration, um, but let me see if there's potentially, no, I just have the group number Carrington 500 series.
[AGENT][NEUTRAL] Um, I could try searching you with the group number.
[CUSTOMER][NEUTRAL] OK, um, so the group number has two letters in the front, so it's LA like Los Angeles and then 0295.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And if not then I can just call the patient.
[AGENT][NEUTRAL] OK, and I can also try searching just um with their name. OK, um, I don't think I don't know that that's gonna work.
[CUSTOMER][NEUTRAL] See if I can get that social.
[AGENT][NEUTRAL] Let's see. Nope.
[CUSTOMER][POSITIVE] Um, if not, it's OK. I can always call back with the social, no worries.
[AGENT][NEUTRAL] Well, last thing I can try, [PII] is if you can spell out their first and last name for me.
[CUSTOMER][NEUTRAL] Of course, um, would it help it would it.
[CUSTOMER][NEUTRAL] Would it help if I gave you the subscriber or the member that I'm actually looking for because it's a member on it's a child on the subscriber.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Sure, um, either one should be perfectly fine.
[CUSTOMER][NEUTRAL] OK perfect so the first name is [PII] and that's [PII] and then last name is [PII], so [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, alright, give me just a moment. That's a unique enough name that I should be able to find them that way.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, and I have a date of birth as well and the addresses.
[AGENT][NEUTRAL] OK, one moment, let's see if I can find them.
[AGENT][NEUTRAL] OK, I think I found him.
[CUSTOMER][NEUTRAL] Looks like this policy has been effective since like [PII], so.
[AGENT][NEUTRAL] Was this for uh dental?
[CUSTOMER][NEUTRAL] It's for dental, yeah.
[AGENT][NEUTRAL] OK, yeah. So I did find it. Um, and then what was [PII]'s date of birth, please?
[CUSTOMER][NEUTRAL] Um, [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] Perfect. OK, thank you for verifying that [PII]. So yes, the policy is active and that effective date was [PII]. Um, and whenever you're ready I can give you that correct policy number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, perfect. I allow me one second actually let me go ahead and.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Come in here. OK, what's that policy number?
[AGENT][NEUTRAL] That is 608-817.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Beautiful thank you so much.
[AGENT][NEUTRAL] And if you would like, I can send you a fax back that shows all of the covered procedures and benefit information.
[CUSTOMER][NEUTRAL] That helps a lot, yes, please. Um, is this a carry series? Do you know if this is a PPO plan or if is it, is it a discount plan?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, so this plan is a bit different. I think it just pays a set dollar amount per covered procedure. Um, let me get that pulled up to verify.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] Yes, so, uh, each procedure has a specific, uh, benefit amount, the dollar amount that it would pay.
[CUSTOMER][POSITIVE] Beautiful. OK, awesome, thank you so much, um, but yeah, um, I can, it's gonna be 980.
[AGENT][NEUTRAL] Of course, what was that fax number for you?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[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 would just put this to your attention, [PII]?
[CUSTOMER][NEUTRAL] Yes, you can just put um [PII] as the attention.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, I will get this sent now. I should get it within 10-15 minutes. Was there anything else I can help you with?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] That is everything thank you so much.
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too take care bye bye.
[AGENT][POSITIVE] Thank you, bye bye.