AccountId: 011433970860
ContactId: f1d7e194-df23-40e8-94db-8e7f61c10c48
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 303779 ms
Total Talk Time (AGENT): 156523 ms
Total Talk Time (CUSTOMER): 151313 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/f1d7e194-df23-40e8-94db-8e7f61c10c48_20250116T16:48_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah we were just gonna see if they could say.
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I don't know if I was just speaking with you, but I just got disconnected. [PII], yes, [PII], uh.
[AGENT][NEUTRAL] [PII]? Is it [PII]. I tried to call you back. I, I, evidently didn't write that number down correct. Is it [PII]?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEGATIVE] That's why I couldn't get you back. I sure was trying.
[AGENT][NEUTRAL] All right, good deal. Well, I know what we need to do. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] It is 02566788.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, so the patient is gonna be dependent [PII] 5 [PII].
[AGENT][POSITIVE] All right, thank you. And it would be my pleasure to help you with the eligibility and benefits for AIA.
[AGENT][NEUTRAL] I am showing that her policy is active. Effective date is [PII].
[CUSTOMER][POSITIVE] Yeah, I agree.
[CUSTOMER][POSITIVE] Absolutely thank you bye bye.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] And what insurance company are you guys?
[AGENT][NEUTRAL] It's APL.
[CUSTOMER][NEUTRAL] APL OK.
[AGENT][NEUTRAL] And there's, yeah, no network participation. It pays at a percentage of UCR.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there like a um email or fax back I can get of the benefits?
[AGENT][POSITIVE] I am already working on that for you because I was fixing to offer that.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Yes, absolutely.
[AGENT][NEUTRAL] And on, on this breakdown, you're gonna get the calendar year max, deductibles, frequencies, limitations. It'll also have our billing information. Now, there is a 12 month waiting period on any major procedures.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 12 months on major, OK.
[AGENT][NEUTRAL] And then
[CUSTOMER][POSITIVE] Perfect, I'll go ahead and jot that down.
[AGENT][NEUTRAL] Yeah, the on the fax packet will not have the group name and number which I can provide if you need that as well.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Yes, that would be great.
[AGENT][NEUTRAL] All right, on the group number is 15, I'm sorry, let me try that again. It's 14564.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Group name is Universal Trucking.
[AGENT][NEUTRAL] Anderson flat bed.
[AGENT][NEUTRAL] Oh, it's getting lunchtime. I almost said flatbread.
[CUSTOMER][POSITIVE] OK, no worries.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Anderson flat bed. OK, perfect. Alright, perfect, and you said that there is no network like no fee schedules or anything you guys are just UCR only.
[AGENT][NEUTRAL] Yeah,
[AGENT][NEUTRAL] And I've got that
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, alright, and they can so they can, yeah, so it's 580.
[AGENT][NEUTRAL] And what is that fax number?
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And let me just verify that fax number. I'm sending this to [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] That's correct. Uh-huh.
[AGENT][NEUTRAL] All right. Well, that is on the way for you, [PII], and also there's no history on file.
[CUSTOMER][POSITIVE] OK, perfect, because they just got on here. Can you tell me, does this plan uh cover orthodontics just out of curiosity?
[AGENT][NEUTRAL] Or those not covered.
[CUSTOMER][NEUTRAL] No no ortho, OK, brothers and ortho, so that's why I was checking, OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] All right, perfect. So that.
[CUSTOMER][NEUTRAL] Should be coming through shortly then for me, um, do you guys do um electronic claims or is it gonna be mail claims?
[AGENT][NEUTRAL] We do both. In fact, uh, on that breakdown, you're gonna get the payer ID which is 60801.
[CUSTOMER][NEUTRAL] On that both OK.
[AGENT][NEUTRAL] And you'll also get the claims address mail, I mean, claims mail address. Oh my gosh, and the fax number.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] All right, well I will watch that then to come through and that is all I needed.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Well, it's been a pleasure to talk to you again, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] And I'm sorry, I couldn't get back to you earlier, but I'm glad you got me. We didn't have to do anything else except get going.
[CUSTOMER][POSITIVE] Yes, absolutely perfect. Well thank you so much and you have a great day.
[AGENT][POSITIVE] I hope you do too, [PII]. Thank you for calling APL and have a lovely day. Take care.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Bye-bye.