AccountId: 011433970860
ContactId: 0cdcae4d-374c-4ab3-abf5-0a21cff68e06
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258428 ms
Total Talk Time (AGENT): 111243 ms
Total Talk Time (CUSTOMER): 89691 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/0cdcae4d-374c-4ab3-abf5-0a21cff68e06_20250423T15:10_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] My name is [PII]. I'm trying to check on a patient's dental coverage.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with dental benefits.
[CUSTOMER][NEUTRAL] You see my narrative that I wrote?
[AGENT][NEUTRAL] Can I please get your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and what's the name of the provider's office you're calling from?
[CUSTOMER][NEUTRAL] Doctor [PII].
[CUSTOMER][NEUTRAL] With the two X-rays.
[AGENT][NEUTRAL] OK, and may I get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] [PII], last name is [PII] Date of birth is [PII]. The policy number is 60.
[CUSTOMER][NEUTRAL] 4459.
[AGENT][NEUTRAL] OK let me pull that up real quick.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK um.
[CUSTOMER][NEUTRAL] I'm gonna try to resend that report again and see if maybe you can get it. If not, um, just let me know I am a.
[AGENT][POSITIVE] OK. I do show that Ms. [PII] does have an active policy with us.
[AGENT][NEUTRAL] Her effective date is [PII], and if you give me your fax number I can send you a fax back with the dental benefit breakdown for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And fee schedule.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, could you, I mean.
[CUSTOMER][NEUTRAL] I don't how long is it? hm, how long is the fax because I really just need to know for endo I don't need everything.
[AGENT][NEUTRAL] It's
[AGENT][NEUTRAL] OK, all right.
[CUSTOMER][POSITIVE] Just like the maximum and deductible?
[AGENT][NEUTRAL] OK, alright. I can look it up. It's gonna be just a second. Let me pull up the facts real quick.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I've got it pulled up, um, and this is just a verified benefits it's not a guarantee of payment. Um, her calendar year maximum is $1000. Her calendar year deductible is $50.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And if you have a code I can look and see on the.
[AGENT][NEUTRAL] And for you.
[CUSTOMER][NEUTRAL] Sure, um, while you're looking at that $50 deductible, has she met that are you using any of the benefits for the year?
[AGENT][NEUTRAL] Let me check real quick for you.
[AGENT][NEUTRAL] She still has her deductible left to pay and.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] She still has her benefit maximum left for the calendar year and that's just to verify her benefits it's not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got you
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, um, OK, so code [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look.
[AGENT][NEUTRAL] OK, um,
[AGENT][NEUTRAL] On this policy, the policy pays $383 for that code.
[CUSTOMER][NEUTRAL] OK, and what about code 3348? Do you cover retreats on root canals or that's not a covered procedure?
[AGENT][NEUTRAL] 333 48.
[CUSTOMER][NEUTRAL] 334 8.
[AGENT][NEUTRAL] Um, that's not showing up on the fax back, so it's non-covered.
[CUSTOMER][POSITIVE] Covered OK.
[CUSTOMER][POSITIVE] Alrighty, that's what I needed to know thank you very much.
[AGENT][POSITIVE] You're very welcome. I appreciate you calling APL I hope you have a wonderful day.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.