AccountId: 011433970860
ContactId: ff4f11f5-7a6f-4f3f-8c33-ce116836e43e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 170619 ms
Total Talk Time (AGENT): 76545 ms
Total Talk Time (CUSTOMER): 66648 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/ff4f11f5-7a6f-4f3f-8c33-ce116836e43e_20250319T19:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey, I'm calling to see if I can get some benefits for a patient.
[AGENT][NEUTRAL] May I have your name and a callback number?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][NEUTRAL] And [PII], may I please have the policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] I don't know what I got. I got a couple of numbers. I'm guessing 02585619 possibly.
[AGENT][NEUTRAL] Let me try that for you.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, it is.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And that is.
[CUSTOMER][NEUTRAL] [PII] of [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy. You're calling in for benefits. Would you like a fax back for this member?
[CUSTOMER][NEUTRAL] Uh, if you just wanna give him to me verbally, that'd be great because he's just standing here.
[AGENT][NEUTRAL] OK, which benefits are you needing me to verify?
[CUSTOMER][NEUTRAL] Uh, dental.
[CUSTOMER][NEUTRAL] so
[AGENT][NEUTRAL] OK, but which expense are you needing me to verify?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh frequencies if you can give me a breakdown of coverage.
[AGENT][NEUTRAL] OK, so for which code or expenses?
[CUSTOMER][NEUTRAL] So like a Max, do you have a max or?
[AGENT][NEUTRAL] So you're needing the calendar year, OK, I can pull that up for you.
[CUSTOMER][NEUTRAL] Yeah, deductible, but I also need several codes.
[CUSTOMER][NEUTRAL] Is do you have like a breakdown of just the frequencies like cleaning and exams and coverage like twice the calendar year or?
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I know oh my gosh, I love it.
[AGENT][NEUTRAL] OK, so in regards to the member's benefits, verification of coverage does not guarantee the payment of the claim for the calendar year max, the member has up to $1500 per covered insured. They do have a $50 deductible up to $150 per family with a deductible which does not apply to the preventative expenses. Now for the frequencies, may I have that code and we uh we do have a limit that's why we submit a fax back.
[CUSTOMER][POSITIVE] Have a great day.
[CUSTOMER][NEUTRAL] You should we'll see you later.
[CUSTOMER][NEUTRAL] That's fine. You can just give me a fax back, but what, uh, what fee schedule do you guys follow?
[AGENT][NEUTRAL] It is based off of the UCR within that area.
[CUSTOMER][NEUTRAL] OK, so it's
[CUSTOMER][NEUTRAL] Um, there is no in network out of network benefits all the same.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, yeah, I'll just take a fax back.
[AGENT][NEUTRAL] OK, may I have a fax number please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Into the attention of [PII].
[CUSTOMER][POSITIVE] Yeah, that's great.
[AGENT][NEUTRAL] I will get that sent over to you.
[CUSTOMER][POSITIVE] Thanks have a great day.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Bye.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye.