AccountId: 011433970860
ContactId: ff83888a-f392-4d0b-9577-5d35df70fae6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180800 ms
Total Talk Time (AGENT): 107819 ms
Total Talk Time (CUSTOMER): 63272 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/ff83888a-f392-4d0b-9577-5d35df70fae6_20250109T14:47_UTC.wav
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[AGENT][POSITIVE] Good morning thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning. I was just trying to get a patient's um eligibility.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you. May I ask your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, [PII], and what is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Um, let's see, um.
[CUSTOMER][NEUTRAL] I have 602-727.
[AGENT][NEUTRAL] And [PII], what is the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][POSITIVE] All right, thank you, and it would be my pleasure to assist you with that eligibility. I am showing that Connie's policy is active. Effective date is [PII]. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, can I get like a fax back of that and um.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Let me see, I guess I don't know what all is on the facts, um.
[AGENT][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Yeah, I guess just like the effective and the frequency.
[AGENT][POSITIVE] And I can help you with that.
[AGENT][NEUTRAL] Yeah, so with this policy, it does participate in the Carrington fee schedule option A. So if you're a Carrington provider, you would use that fee schedule option A.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If not, just use your fee schedule and we pay according to the guidelines of the policy.
[AGENT][NEUTRAL] And on this breakdown you're gonna get the calendar year max deductibles, frequencies, limitations you'll get the billing information.
[AGENT][NEUTRAL] And the procedures listed that are covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] Now the benefit amount listed on the fee schedule on our fax back is the amount that we pay toward the covered procedures.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and then is there also a way I can get the fee schedule faxed to me as well, or?
[AGENT][NEUTRAL] I'm working on that right now for you, [PII]. What is the fax number?
[CUSTOMER][NEUTRAL] OK, alright.
[CUSTOMER][NEUTRAL] OK, um, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let me just verify that fax number if you don't mind. [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, so that is on the way for you and as of right now, of course, she has not used any of her benefits nor met her deductible for [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, that is it.
[AGENT][POSITIVE] Well, it's been a pleasure to assist you with that breakdown today, [PII]. Thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] Bye.