AccountId: 011433970860
ContactId: 11228400-c330-44a5-a051-57f8d855e0b5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 520479 ms
Total Talk Time (AGENT): 204271 ms
Total Talk Time (CUSTOMER): 162584 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/11228400-c330-44a5-a051-57f8d855e0b5_20250410T17:34_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII] calling from Jefferson Dental.
[AGENT][NEUTRAL] OK, I'm sorry, what is your name?
[CUSTOMER][NEUTRAL] My name is [PII] calling from Jefferson Dental.
[AGENT][NEUTRAL] OK, [PII], and how can I help you?
[CUSTOMER][NEUTRAL] I'm calling to verify the eligibility and benefits for your patient. Could you please help me with that?
[AGENT][NEGATIVE] I can assist you. You're very, your voice is very faint. I can barely hear you. Can you provide the policy number for me?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Uh, it's the policy number is 02013730.
[AGENT][NEUTRAL] That's 02013730?
[CUSTOMER][POSITIVE] It's right.
[AGENT][NEUTRAL] OK, and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And you said you're calling for dental benefits?
[CUSTOMER][POSITIVE] It's dental benefits.
[AGENT][NEUTRAL] OK, would you like to schedule a benefits faxed over to you?
[CUSTOMER][NEUTRAL] Uh, yes, ma'am, in, uh, actually I have already faxed, but I need some.
[CUSTOMER][NEUTRAL] Some details for this patient.
[AGENT][NEUTRAL] OK, so you've already received the schedule of benefits you have questions regarding the schedule?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] OK, what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]'s date of birth?
[CUSTOMER][NEUTRAL] It's [PII], ma'am.
[AGENT][NEUTRAL] And his date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that information and what information can I assist you with today, [PII]?
[CUSTOMER][NEUTRAL] So the patient policy is active, right?
[AGENT][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] OK, what was the group number, ma'am?
[AGENT][NEUTRAL] I show that the group number is 17701.
[AGENT][NEUTRAL] Universal Trucking is the name of the group.
[CUSTOMER][NEUTRAL] It's 17081, ma'am.
[AGENT][NEUTRAL] 17708.
[CUSTOMER][NEUTRAL] 8 and the group name is Universal Turing, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Is there any use amount, sir, and could you please confirm deductible would be 50 family that will be 150 and annual max is 1500, right?
[AGENT][NEUTRAL] OK, so you're wanting to verify if the deductible has been satisfied and you wanna know what amounts have been used or the accumulations?
[CUSTOMER][NEUTRAL] And what was the used amounts for individual deductible and family deductible?
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEGATIVE] OK, so at this moment, you said the patient is [PII]. He has not satisfied his deductible and has not used any of his benefits. I'm showing one dependent on the policy that's used $413.20 of the benefit. Deductible is not satisfied.
[CUSTOMER][NEUTRAL] Uh, so, and what was the annual max is and what was the annual max? Annual max is uh 1500, right?
[AGENT][NEUTRAL] Mhm, do you have the schedule of benefits in your hand?
[CUSTOMER][NEUTRAL] I'm, I'm asking, uh, what was the annual maximum?
[AGENT][NEUTRAL] As stated on the schedule, it's $1500 per covered insured.
[CUSTOMER][NEUTRAL] Uh, is there, is there any used amount for annual max?
[AGENT][NEUTRAL] One of the dependents has used $413.20 but you said your patient is [PII]. He hasn't used any of his $1500.
[CUSTOMER][NEUTRAL] I'm asking uh used amount for annual max.
[AGENT][NEUTRAL] For the family or for [PII]?
[CUSTOMER][NEUTRAL] For the annual maximum, it was $1500 right? And what was the used amount?
[AGENT][NEUTRAL] Are you asking for the used amount for your patient [PII] or the entire family?
[CUSTOMER][NEUTRAL] Patient [PII].
[AGENT][NEUTRAL] There's nothing used. He has the 1500 remaining.
[CUSTOMER][NEUTRAL] OK. Is patient is policyholder?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] This patient is policyholder?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK and uh is there any history on file which might affect the frequency?
[AGENT][NEUTRAL] OK, so I'm showing the last claim received for [PII] is for year [PII].
[AGENT][NEUTRAL] Is there a particular procedure code?
[CUSTOMER][NEUTRAL] What was the procedure code?
[AGENT][NEUTRAL] OK, he has several. Do you have a particular procedure code that you're looking for?
[CUSTOMER][NEUTRAL] Actually, I need the preventative and basic services.
[AGENT][NEUTRAL] Basic services?
[CUSTOMER][NEUTRAL] Preventive basic services.
[AGENT][NEUTRAL] OK, I'm sorry, I'm not understanding what you're saying.
[AGENT][NEUTRAL] Did you say preventive and basic?
[CUSTOMER][NEUTRAL] Ma'am, is there any
[CUSTOMER][NEUTRAL] I, is there any history on file which might affect the frequency? I need the.
[AGENT][NEUTRAL] OK, not for [PII]. He hasn't used anything for [PII]. Are you wanting past history?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yes, ma'am. It might affect the frequency. Please give me which might affect the frequency.
[AGENT][NEUTRAL] OK, I'm sorry, I can't hear you, [PII].
[CUSTOMER][NEUTRAL] Ma'am, is there any history on file which might affect the frequency?
[AGENT][NEUTRAL] OK, so that's what I'm saying there are no claims on file for this year. The last claims I'm showing received was for year [PII]. So can you tell me what services are being rendered for the patient?
[CUSTOMER][NEUTRAL] Preventative and basic services.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Ma'am, for [PII], what was the date of date of service?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] What was the procedure code?
[AGENT][NEUTRAL] It's basic services D0230.
[CUSTOMER][NEUTRAL] What I'm asking
[CUSTOMER][NEUTRAL] D 0 230. OK. Until that, is there any other?
[AGENT][NEUTRAL] And it's, it's not your claim, so we can't really provide information if it's not your claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So can you tell me what services you're looking to provide for [PII]?
[CUSTOMER][NEUTRAL] OK, is
[CUSTOMER][NEUTRAL] Ma'am, these are all dental history, right?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] These are all dental services, right?
[AGENT][NEUTRAL] Yes, it's a dental policy, so it's dental services.
[CUSTOMER][NEUTRAL] OK, thank you. And uh uh
[CUSTOMER][POSITIVE] OK, thank you. Just feelings strongly, ma'am.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEGATIVE] The fillings downgraded?
[AGENT][POSITIVE] No downgrades for fillings.
[CUSTOMER][NEUTRAL] For crowns.
[AGENT][NEUTRAL] What was the question regarding crowns?
[CUSTOMER][NEGATIVE] For crowns is downgraded.
[AGENT][POSITIVE] There are no no downgrades.
[CUSTOMER][NEUTRAL] Is there any waiting period?
[AGENT][NEUTRAL] It's a 12-month waiting period?
[CUSTOMER][NEUTRAL] OK. Does, what, what was the service, ma'am? It's preventative basic or major services.
[AGENT][NEUTRAL] OK, so there's a waiting period for major services. The policy was active in year [PII], so they've exceeded the 12 month waiting period for major services.
[CUSTOMER][NEUTRAL] OK, thank you. Does missing tooth cloths apply?
[AGENT][NEGATIVE] There is a missing tooth cloth.
[CUSTOMER][NEUTRAL] Our major service is paid on a date.
[AGENT][NEUTRAL] Either or, and [PII], did you say you have a copy of the schedule of benefits?
[CUSTOMER][NEUTRAL] But in fact the these uh information is not there, ma'am. OK, thank you. I'm done with this patient. Can I get your call reference number?
[AGENT][NEUTRAL] OK, the information that you ask is on the schedule and it's not a problem to provide it to you. You'll use my name and today's date as reference for today's call. It's [PII].
[AGENT][NEUTRAL] [PII] last [PII] is [PII] and did you have any other questions, [PII]?
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEUTRAL] Uh, could you
[CUSTOMER][NEUTRAL] Could you please spell out your name?
[AGENT][NEUTRAL] My name?
[AGENT][NEUTRAL] Spell my name.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] [PII],
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] First initial last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you. Thank you for the information. Have a great day. Bye bye take care.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL, [PII]. Have a good day as well.