AccountId: 011433970860
ContactId: 0bdb42e3-ab7e-4772-9823-c27c564efe95
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249899 ms
Total Talk Time (AGENT): 110448 ms
Total Talk Time (CUSTOMER): 97751 ms
Interruptions: 1
Overall Sentiment: AGENT=1.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/0bdb42e3-ab7e-4772-9823-c27c564efe95_20250116T16:50_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, [PII]. My name is [PII] calling from a dental office. How are you doing today?
[AGENT][POSITIVE] I'm great, thanks for asking. How are you?
[CUSTOMER][POSITIVE] I'm doing great. Uh, thank you for asking as well. So, um, I'm calling to check on uh eligibility and benefits for a patient in the office.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] OK, sure. Uh my name, that's Partner, that's [PII].
[CUSTOMER][NEUTRAL] And uh callback number, uh direct number, that's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] And could you verify that patient's policy number?
[CUSTOMER][NEUTRAL] OK. So, policy number that's gonna be 0255.
[CUSTOMER][NEUTRAL] 0560
[AGENT][NEUTRAL] Alright now, could you verify, are you calling for dental or medical?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Dental?
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] All right. That's uh [PII]. That's [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. And the first name, that's uh [PII] And uh that's uh [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] This policy has been active since [PII] and it's currently active. You're calling to verify benefits and eligibility. This member's policy has a maximum benefit amount of $500 per calendar year with a $50 deductible that does not apply to preventative services, and this is not a guarantee of benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK, sure. What's the ID?
[CUSTOMER][NEUTRAL] OK. All right. Thank you for that. Uh, what's the pay ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK. Just a moment. Uh, bear with me. You said 80?
[AGENT][NEUTRAL] 60801 and I can send you a fax back of these benefits if you're having a hard time hearing me.
[CUSTOMER][POSITIVE] Uh, I would appreciate that. OK. I would appreciate that. Um, my fax number, whenever you're ready, I can provide my fax number.
[AGENT][POSITIVE] I'm ready for a partner.
[CUSTOMER][NEUTRAL] OK. That's uh 279.
[CUSTOMER][NEUTRAL] 399
[CUSTOMER][NEUTRAL] 4849.
[AGENT][NEUTRAL] So I have [PII].
[CUSTOMER][NEGATIVE] No, that's incorrect. That's 279.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 399
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Alright, I'm gonna send this over for you. The member has not utilized any of their benefits for [PII] or met their deductible?
[AGENT][NEUTRAL] And there's no history on file.
[CUSTOMER][NEUTRAL] OK. And he's on file?
[CUSTOMER][NEUTRAL] OK. Missing interest plus?
[AGENT][NEUTRAL] There is a missing tooth cloth and that's on the very first page that I sent over for you. Also, on the information that I sent over it's gonna have the payer ID, the mailing address, the fax number, the category of expenses, frequencies of services, the calendar year max, the yearly deductible, then on the.
[AGENT][NEUTRAL] Second through 4th page is gonna have the parent the letter it's gonna have the CPT codes, the descriptions, and then on the limitation column there's gonna be letters in parentheses on the very last page there's a key box partner with each letter in parentheses giving you the limitation for each alphabet.
[CUSTOMER][POSITIVE] OK, thank you. I appreciate that. All right. uh, what's the call reference number?
[AGENT][NEUTRAL] Is there anything else that I can assist you with today? We don't provide those. You can use my name in today's date as a reference.
[CUSTOMER][POSITIVE] OK, thank you. All right, thank you for the time. Keep up the good work. Bye-bye for now.
[AGENT][POSITIVE] Thanks for calling APL. You have a great one as well. Goodbye.
[CUSTOMER][NEUTRAL] Bye bye.