AccountId: 011433970860
ContactId: 0faadc9f-ee84-4737-b959-4c6c743e387a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 344940 ms
Total Talk Time (AGENT): 137392 ms
Total Talk Time (CUSTOMER): 185437 ms
Interruptions: 4
Overall Sentiment: AGENT=1.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/0faadc9f-ee84-4737-b959-4c6c743e387a_20250115T22:49_UTC.wav
--------------------------------------------
[CUSTOMER][NEUTRAL] It's one of these things you gotta.
[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi [PII], my name's [PII]. I'm calling from a dental provider. I was trying to see how fast I if I could get a.
[CUSTOMER][POSITIVE] Fast benefits um quote for a member.
[AGENT][POSITIVE] Yeah, I'd love to help you with that today. Do you have, um, sorry, do you mind if I grab a quick policy number from you?
[CUSTOMER][NEUTRAL] Um, sure, that is.
[CUSTOMER][NEUTRAL] Well I mean I don't, I have a member ID and a group number.
[AGENT][NEUTRAL] Oh, it's that member ID. I'm sorry.
[CUSTOMER][NEUTRAL] OK, no, it's OK, 232-0071?
[AGENT][POSITIVE] Perfect. And while I'm pulling up that policy, Ms. [PII], do you mind if I'll just snag a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. I appreciate that. And would you be able to verify for me, pretty please, your patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Perfect. And you said you're needing some benefit information, is that correct?
[CUSTOMER][NEUTRAL] Yes, I mean, I don't do y'all offer uh benefits breakdown via fax?
[AGENT][NEUTRAL] Only for my dental patients do we do fax ones, but I can give you a verbal breakdown.
[CUSTOMER][NEUTRAL] For verbal.
[CUSTOMER][NEUTRAL] OK, let me um.
[CUSTOMER][NEUTRAL] Uh, let's see, let me get a form here real quick quick so I can get that information.
[AGENT][POSITIVE] No worries. Let me know when you're ready.
[CUSTOMER][POSITIVE] Alright, she'll get that for you, OK? You're welcome. See you next time.
[CUSTOMER][NEUTRAL] And he did give us a copy of the card, um.
[CUSTOMER][NEUTRAL] Let me get back into his.
[CUSTOMER][NEUTRAL] Um, so this is a secondary plan.
[AGENT][NEUTRAL] Yes, we are his secondary supplemental insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then it looks like it has on the um I do have a claims mailing address and payer ID so it won't need that.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] So I guess we'll go into um.
[CUSTOMER][NEUTRAL] His effective date
[AGENT][POSITIVE] You bet we'll start from the top. So, Mr. [PII] is um current and active with us. He has been effective since [PII].
[AGENT][NEUTRAL] Um, as far as benefit information, do you know if you're needing his inpatient or outpatient benefits today, ma'am?
[CUSTOMER][NEUTRAL] I am not sure what network do y'all utilize.
[AGENT][NEUTRAL] Um, we just follow because we're the secondary, we just follow major medical.
[AGENT][NEUTRAL] It's like a gap policy.
[CUSTOMER][NEUTRAL] Mm, I have no clue if we would be out of network or in or out.
[CUSTOMER][NEUTRAL] Um, the provider he saw today.
[CUSTOMER][NEUTRAL] Is um.
[CUSTOMER][NEUTRAL] Under the connection dental.
[CUSTOMER][NEUTRAL] Health Network, um.
[AGENT][NEUTRAL] I'm so sorry. So, are you looking for like, I'm so sorry. I just want to make sure I'm getting this right. Are you looking for medical benefits, like, or like dental?
[CUSTOMER][NEUTRAL] No, dental.
[AGENT][NEUTRAL] OK, the policy number you gave me was like his gap insurance is like uh secondary to his major medical. Let me see if he has any dental policies with us.
[CUSTOMER][NEUTRAL] Yeah, he said, yeah, so he, he gave, he oh he does no OK so this is.
[AGENT][NEUTRAL] He does not.
[AGENT][NEUTRAL] Yeah, where are we?
[CUSTOMER][NEUTRAL] OK, well that explains a lot we were.
[AGENT][NEUTRAL] We do offer dental policies, but he does not have a dental policy with us.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, he, he would have to, so I think he believes he does. I think he thinks he has all like a secondary coverage.
[CUSTOMER][NEUTRAL] Um, dental coverage through, through y'all, um, so if there's a problem or you thought he's supposed to have that, he needs to get with his HR.
[AGENT][NEUTRAL] Yeah, absolutely. Um, there's times like if he got into a car accident and smashed out all his teeth, you know, we might cover things done dentally, but like, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm, accidental dental, yeah, yeah, yeah, yeah, through the medical. I got you OK so it's just a it's a it's a.
[AGENT][NEUTRAL] Yep, yep.
[CUSTOMER][NEUTRAL] A dental writer through the medical due to accident or injury.
[AGENT][NEUTRAL] Yeah and I it isn't even necessarily a dental writer it's just like, yeah, like if he was in a situation where he was in a hospital and there was a dental issue, you know, but it wasn't, I, I mean honestly it's if they build a major medical, yeah.
[CUSTOMER][NEUTRAL] I guess is what I could explain to him.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Medically related but it's yeah.
[CUSTOMER][NEUTRAL] OK, OK, alright, well that made it easier for me but um yeah, I, I'll have to break it to him, see if he, if, no, not at all.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Oh, I'm sorry. And his, his HR group might have information on, like, I mean, cause I can only see what we offer, but his HR group might have more information on what his dental stuff is.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, so he has a couple different cards, but he said they they designed this one card that has both, both of his primary health plan and secondary health plan is how it's printed, but he does believe he has dental through both so that's that's somewhere he has to they have to make that you know get him to understand the coverage, um, make it more clear on his coverage right well thank you so much for your help I appreciate it.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Hey, it's my pleasure thank you so much you have a wonderful day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.