AccountId: 011433970860
ContactId: 0af20a58-2b00-4b9c-a080-934ef6a50f20
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 920859 ms
Total Talk Time (AGENT): 308100 ms
Total Talk Time (CUSTOMER): 186777 ms
Interruptions: 6
Overall Sentiment: AGENT=1.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/0af20a58-2b00-4b9c-a080-934ef6a50f20_20250512T19:17_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey Miss [PII], my name is [PII]. I am calling from Penley Family Dentistry, and I'm calling to check and see if my patient has, um, current dental benefits.
[AGENT][NEUTRAL] OK, [PII], you're wanting to verify if the policy is active, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am mhm.
[AGENT][POSITIVE] Alright, yes ma'am, I can certainly help you with that. And [PII], what is a good callback number for you please?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] Policy number is 02622782.
[AGENT][NEUTRAL] OK, thank you. One moment while I get that information pulled up.
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that Mr. [PII] is a subscriber on this policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK, and he does have out of network benefits?
[AGENT][NEUTRAL] Uh, this is a new policy, so let me look to see.
[AGENT][NEUTRAL] If I can
[AGENT][NEUTRAL] If it has a network, I don't know that I'm not familiar with this one, so just one second, let me pull some additional information if it's available.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Yeah, it's brand new. His group has been with like Guardian for like as long as I've been working here, which was like 89 years. They've had Guardian and they just switched to you guys.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, and this is just a new policy overall that I'm not OK, so give me just a moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] I'm gonna have to try to locate some information.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] We're gonna try to learn something new together if you have time, [PII] here I'm.
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[AGENT][NEUTRAL] OK, let's see
[AGENT][NEUTRAL] Since this policy was just issued, I'm gonna try to see if I can locate.
[AGENT][NEUTRAL] Someone else because I can't see his policy information yet so just.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Looking to see if someone else has the same type of coverage that there is a policy that I can look at.
[AGENT][NEGATIVE] Oh I don't think right.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Or breaks I got them checked in they'll come get him in just a minute, OK.
[AGENT][NEUTRAL] OK, I'm gonna, I'm asking one of my teammates about this.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Since this group is brand new, there's, I don't have anything to look out for them.
[CUSTOMER][NEUTRAL] Yeah, because like the whole group is new.
[AGENT][NEUTRAL] Yeah, but they're all new and they were all issued at the same time. I just, this is the first call I've gotten for this group, um.
[AGENT][NEUTRAL] And I, I mean, I knew it had to be, yeah, um, I could tell by the way that I was trying to look for some of the information that it is sick.
[CUSTOMER][NEUTRAL] Well, there'll be plenty more because it's a big group for us here.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, this is, um, I don't know if you're familiar with it, but this is in its out in [PII], so like, um, they work with like NASA and stuff like that so it's a big old group.
[AGENT][NEUTRAL] Mm, I'm actually in [PII].
[AGENT][NEUTRAL] Oh, I'm, I am. I, I live in [PII], so yes, yeah.
[CUSTOMER][NEUTRAL] Oh, so you know about dentist. So yeah, so it's the dentist group.
[AGENT][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] And we have tons of people because I mean there's like a ton of people that work out of this and then I would say probably half of them work from home too so it's a big, big, big group.
[AGENT][POSITIVE] Oh wow.
[AGENT][NEUTRAL] Well, I can see it's not listed as tenna, so, yeah, I would not have known that.
[CUSTOMER][NEUTRAL] Yeah, I think it's like relativity space or something is what the group is and then some of them even come across as S3 instead of thins.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I guess so. I mean unless Doctor [PII] does it as a post op.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So much
[AGENT][POSITIVE] I, I'm so grateful for your patience, [PII], and I apologize about the delay.
[CUSTOMER][POSITIVE] No, you're fine because I'm working while you're working. I'm working while you're working, so no worries.
[AGENT][POSITIVE] OK, all good. OK, good. Thank you.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Talking to somebody else.
[CUSTOMER][NEUTRAL] I guess
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] As of right now, he has money.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] He
[AGENT][NEUTRAL] Oh, I'm.
[AGENT][NEUTRAL] Bear with me just a second.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so I've got it. I can send you the fax back, a fax back, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, so just now let me get the proper fax back pulled up so that I can send it to you. So you'll at least have the correct benefit information. Yes, yes, I've sorted out some things in this call, definitely. Alright, so just give me a moment to get his, so and this will be on this fax side, but his calendar year max is $750 with a $50 deductible.
[CUSTOMER][POSITIVE] At least you'll be ready for the next person that calls, right?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me just get him
[AGENT][NEUTRAL] Keyed on here.
[AGENT][NEUTRAL] And of course, we do not have any history just for that would be on the facts back, but we do not have any history for you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] But I'm glad that you thank you for sharing with me that this is affiliated with [PII] because we do a lot of work with these different um entities, these groups, but you know they don't show up for us.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, and so the way that this works like they contract out so I think this relativity space is part of their contract, guys, um, but there'll be like relativity space there'll be S3, um, they come off of like one of them one time came under like a school name because apparently like.
[AGENT][POSITIVE] Uh, I got you.
[CUSTOMER][NEUTRAL] They must have like a little daycare for like some of the working parents there and so there we have a couple of women that work in the daycare and they said something else and I'm like you work for [PII] and she's like, yeah I'm like, OK, so like there's so many different branches that branch off but it's all through tennis.
[AGENT][NEUTRAL] For, uh, yeah, sure, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, very interesting, very, very interesting.
[CUSTOMER][NEUTRAL] So y'all gonna get a large group, so y'all just picked up a big one.
[AGENT][POSITIVE] Yay, well, that's great. All right, so.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Still bear with me just a second, [PII] you're
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Do you, can you bear with me just another minute?
[CUSTOMER][NEUTRAL] Yeah, I'm, I'm looking at somebody else's insurance while you're doing that, so I'm not, you're not bothering me at all.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, I'll get you checked in.
[AGENT][POSITIVE] OK, and give me a good fax number for you, [PII], and I'll send this over to you.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, and I'm gonna just repeat that back one second as soon as it'll pull up where I can.
[AGENT][NEUTRAL] OK, and you said [PII].
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, well that
[AGENT][NEUTRAL] That has just been sent to you so provided there's not any type of technical glitch, you should be receiving that in just a few minutes. Um, also, well, it may take, I mean it's gonna take a few minutes for it to come through.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] if you will end up filing a claim with us, [PII] for him, once the claim has been processed, we do have a portal in which you should be able to check his claim status.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And the website for that is secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII]. OK, very good. Alright, thank you so much.
[AGENT][NEUTRAL] Mhm. Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, well thank you for calling APO if that is all I can help you with today, um, it was my pleasure in speaking with you. Thank you again for your patience and you and I will probably speak to each other again if you have a lot of business from this group.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I'm sure, yes, ma'am.
[AGENT][POSITIVE] OK. Well, have a wonderful afternoon.
[CUSTOMER][POSITIVE] We do. Yes, ma'am. Thank you. Bye-bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.