AccountId: 011433970860
ContactId: 00e352fa-63d6-4620-8b1f-74768ec2d13d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 133589 ms
Total Talk Time (AGENT): 63063 ms
Total Talk Time (CUSTOMER): 71522 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/00e352fa-63d6-4620-8b1f-74768ec2d13d_20250305T14:46_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm just, I'm calling from a dental office and just wanted to verify uh that a patient has out of network benefits.
[AGENT][NEUTRAL] Sure, I could assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] Mhm my name's [PII] and the number is [PII].
[AGENT][NEUTRAL] Did you say your name was [PII]?
[CUSTOMER][NEUTRAL] Uh huh yes.
[AGENT][NEUTRAL] [PII], can I have a policy number of the member that you're inquiring?
[CUSTOMER][NEUTRAL] I have 10 uh 1,038,730.
[AGENT][NEUTRAL] Network benefits for.
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, um, that is, hold on, let me get back to that screen. Her name is [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] Thank you and you're calling to verify outpatient benefits, so don't, um, I'm about to call you [PII].
[CUSTOMER][NEUTRAL] Your
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Just out of network benefits it's for dental, uh huh.
[AGENT][NEUTRAL] When did this policy.
[AGENT][NEUTRAL] This policy does not have a network. The member has the access, open access to go wherever they desire to go because the policy is not a PPO or HMO. It's just a standard dental policy that covers dental services due to that being a truck driver, meaning that he can go wherever he desired to go.
[CUSTOMER][NEUTRAL] Antibiotic
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that sounds good.
[AGENT][NEUTRAL] So as long as the assignment of benefits are signed, when you submit the claim, then the payment would definitely go to the provider.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, perfect. Alright, and is there any way you can tell me what can you tell me what what type of coverage is listed for endoonics?
[AGENT][NEUTRAL] Is there anything else that I can assist you with? Go ahead.
[AGENT][NEUTRAL] I can send you a fax back if you would like of her entire dental schedule.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I don't really need all that. That's OK.
[AGENT][NEUTRAL] What is your procedure code?
[CUSTOMER][NEUTRAL] Uh D 3330.
[AGENT][NEUTRAL] So that falls on the major at 40%.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] OK, well thank you so much for your help.
[AGENT][POSITIVE] You're welcome, [PII], thanks for calling APL and you have a great day.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][POSITIVE] Thanks you have a good day as well. Take care.
[AGENT][POSITIVE] Thanks goodbye. You too.