AccountId: 011433970860
ContactId: 0b8f640c-a9b9-40ce-91f4-08f5330f1692
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 335119 ms
Total Talk Time (AGENT): 186190 ms
Total Talk Time (CUSTOMER): 126291 ms
Interruptions: 6
Overall Sentiment: AGENT=1.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/0b8f640c-a9b9-40ce-91f4-08f5330f1692_20250205T21:48_UTC.wav
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[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Hello. Thank you for calling APU. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi, um, what was your name? I'm sorry.
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] Can you spell it for me?
[AGENT][NEUTRAL] I sure can. It's [PII] yes.
[CUSTOMER][NEUTRAL] Alright, thank you so much. Um, I was just calling regarding a patient. I'm calling from a provider's office. I'm trying to see if this patient has out of network dental benefits.
[AGENT][NEUTRAL] Hm.
[AGENT][POSITIVE] OK, be glad to help you. Go ahead and give me your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] My name is [PII]. The member's policy number is 613676.
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please, ma'am.
[CUSTOMER][NEUTRAL] Alright, it is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for that information. Now, what's your name, uh, patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] Oh right it looks like she is the insured on this dental plan original effective date [PII]. She is current and active, but I must advise that verification of coverage is not a guarantee of payment on a claim, but she can go to any dentist that she wants to go to. This benefit, have you received the faxed back a benefit yet today, uh, [PII]?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][POSITIVE] OK, because yeah, it's paid on a free schedule. She can go to any dentist she chooses to go to, but I'll tell you what, go ahead and give me a good fax number, [PII], and I'll get that schedule of benefits faxed over to you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's 225-298.
[CUSTOMER][NEUTRAL] 5555.
[AGENT][NEUTRAL] Alright, [PII], I'm gonna repeat that fax number back, make sure I'm keying this in correctly. That fax number is area code [PII]. Was that correct?
[CUSTOMER][NEUTRAL] Yeah yeah.
[CUSTOMER][NEUTRAL] Yes, ma'am. I do have a few other questions as well.
[AGENT][NEUTRAL] Yes, ma'am. Yes, ma'am. How, what else can I answer for you?
[CUSTOMER][NEUTRAL] OK, um, now, is there any missing two calls or waiting period.
[AGENT][NEUTRAL] Let's see, I'm gonna have to get that fax back pulled up because she is in option B. There's no waiting period, um, because she's been on since [PII].
[CUSTOMER][NEUTRAL] Yeah, he is.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You got to know.
[CUSTOMER][NEUTRAL] Got you. And what about a missing two clauses? OK.
[AGENT][NEUTRAL] Yeah, I'm missing too close. Let me look.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] See.
[CUSTOMER][NEUTRAL] I see
[CUSTOMER][NEUTRAL] Oh.
[AGENT][POSITIVE] Yes, she does have a missing cut clause, and that will be on the first page of that backpack of benefit with all that good information.
[CUSTOMER][POSITIVE] Good
[CUSTOMER][NEUTRAL] OK. And the history on, is on the fax back as well?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, ma'am. No history will be on it, but let me look and see when's the last time.
[CUSTOMER][NEUTRAL] So as far as his history, um, this is what I need to know. So pretty much we just do extractions, dentures, and implants here. So I just need to know first if you have any history with dentures or partials.
[AGENT][NEUTRAL] Let's see, get that.
[AGENT][NEUTRAL] History pulled up.
[CUSTOMER][NEUTRAL] All right, baby
[AGENT][NEUTRAL] Partials I can tell you right now are not covered under the plan, but dentures are, so let's see, no, ma'am.
[CUSTOMER][NEUTRAL] No partials, OK.
[CUSTOMER][POSITIVE] I'm good. Oh, thank you.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] She hadn't been in the dentist since [PII] and that was just for extractions.
[CUSTOMER][NEUTRAL] Lu
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, she don't have any history that's gonna affect what she's gonna have done today mm, but every code that is covered will be on that faxed back a benefit and you should have it in just about 5 minutes, OK?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, and one of the frequency is on there too, like as far as dentures, how often? OK, alrighty, and implant information as well.
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[AGENT][POSITIVE] Yes, ma'am, for sure.
[AGENT][NEGATIVE] Uh, if it's not on this fast back, it's not covered.
[CUSTOMER][NEUTRAL] OK. Well, can you just tell me if the implants are covered just so I can know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] It plans, yeah, they're, they're not covered here at all. Mhm.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEGATIVE] Yeah, yeah, but if that code is not on the facts, it's not covered at all.
[CUSTOMER][NEUTRAL] Alright, you said I should get it within about 5 minutes?
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, ma'am. I'm sending it right now.
[CUSTOMER][POSITIVE] Alrighty thank you.
[AGENT][POSITIVE] Yes, ma'am. Is that all I can help answer for you today, [PII]?
[CUSTOMER][NEUTRAL] That's it. I just need the call reference number.
[AGENT][NEUTRAL] Well, we don't give call reference numbers, but you can use my name in today's date, [PII], if you need to do so, OK.
[CUSTOMER][POSITIVE] Alright thank you.
[AGENT][POSITIVE] Yes, ma'am, and thanks for calling APL [PII]. You have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.