AccountId: 011433970860
ContactId: 018d0955-55ad-4222-8598-eb04f2afe437
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266320 ms
Total Talk Time (AGENT): 121071 ms
Total Talk Time (CUSTOMER): 109161 ms
Interruptions: 3
Overall Sentiment: AGENT=1.6, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/018d0955-55ad-4222-8598-eb04f2afe437_20250421T16:43_UTC.wav
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[AGENT][POSITIVE] And thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I was calling because I got the fax back for patients benefits, but I have a couple of questions.
[AGENT][NEUTRAL] OK, so this is on a dental policy that you have received the fax back but have additional questions?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you. And who am I speaking with?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] He is
[CUSTOMER][NEUTRAL] It's 259-430-07.
[AGENT][NEUTRAL] OK, thank you one moment while I get the member's information pulled up please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] yeah.
[CUSTOMER][NEUTRAL] That's your date of birth.
[CUSTOMER][NEUTRAL] The other one
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And you.
[AGENT][NEUTRAL] OK, and any information that I do provide for you that would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's [PII], uh, [PII].
[AGENT][NEUTRAL] OK, thank you. Now, give me a moment to get the fax back information pulled up for him, please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Uh, you're welcome. I'm actually gonna have to reload this page. It's for some reason not pulling up for me. I'm so sorry. Uh just a moment, please.
[CUSTOMER][POSITIVE] That's OK. Thank you.
[AGENT][NEUTRAL] OK. So, yes, sir, I have that facts that pulled up. How can I help you, [PII]?
[CUSTOMER][NEUTRAL] Um, yeah, just to confirm the policy is just for restored, or sorry, um, preventative and basic, right?
[AGENT][NEUTRAL] That is correct. Anything that is not listed on the fact that is not covered.
[CUSTOMER][NEUTRAL] OK perfect um and is it a calendar year plan?
[AGENT][NEUTRAL] Yes, sir, if you'll notice at the very top under the patient's name and effective date. It just, it should say calendar year maximum.
[AGENT][NEUTRAL] And then below that calendar year deductible.
[CUSTOMER][NEUTRAL] OK, got you.
[CUSTOMER][NEUTRAL] Yeah and then um is there a coordination of benefits or no?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No coordination. OK, um, and then have they used any of their max or any of their deductible?
[AGENT][NEUTRAL] I can check that for you, one moment. There is no history on file for this member.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] That answers my other questions as well um and then um one other thing though is, is there a timely filing day limit for claims?
[AGENT][NEUTRAL] No, no, there is not. And the effective date on this policy is [PII], which should also be on your fax back. I'm sorry, [PII]. I think, I think that's, no, no, no, no, I think, yeah. No, I'm sorry, it should be [PII].
[CUSTOMER][NEUTRAL] 2 [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it, thanks for clarifying that. Um, yeah, alright, and I think let me just double check, yeah, that, that's actually it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then I'm not sure
[AGENT][NEUTRAL] OK, well, the, um, whomever you spoke to a while ago, did they also tell you [PII] about our portal called the online service center?
[CUSTOMER][NEUTRAL] Yeah, um, I let the office manager know so she can set it up.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK. Good. All right then. Well, is there anything else that I could help you with today?
[CUSTOMER][POSITIVE] Uh, no, [PII], you've been great. Thank you for your help.
[AGENT][POSITIVE] Well, you're certainly very welcome and it was my pleasure. So thank you again for calling APL Allan if that's all I can help with, and I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Uh, thank you very much.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye-bye.