AccountId: 011433970860
ContactId: 1242c350-efc9-4361-98b6-41456abec95f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 396700 ms
Total Talk Time (AGENT): 151482 ms
Total Talk Time (CUSTOMER): 198928 ms
Interruptions: 1
Overall Sentiment: AGENT=2.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/1242c350-efc9-4361-98b6-41456abec95f_20250109T15:28_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling ATL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Yes ma'am, my name is [PII]. I'm calling from a dental practice. I'm trying to verify benefits for a patient please.
[AGENT][POSITIVE] Yeah, I'd love to help you with some benefits today, Miss [PII], and do you mind if I get a good call back number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Wonderful, thank you, and your member's policy number please?
[CUSTOMER][NEUTRAL] Um, let's see, I only have her social security number. She'd give me a number that was a [PII], but she wasn't sure what that number was on her card, but I do have her social.
[AGENT][POSITIVE] No worries, and that [PII] is actually gonna be our payer ID.
[CUSTOMER][NEUTRAL] OK, so that's let me correct that because that's what I don't think she knew what she was giving me, so that's payer ID.
[CUSTOMER][NEUTRAL] Bear with me, OK, and her social is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Wonderful. Give me a moment to look that up.
[AGENT][POSITIVE] All right, perfect. And um her first and last name, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And her birth date is [PII].
[AGENT][POSITIVE] Wonderful thank you so much and let me see.
[AGENT][NEUTRAL] Let me give you her policy number real quick. It is 02552506.
[CUSTOMER][NEUTRAL] 02552506
[AGENT][POSITIVE] Yes, absolutely. And if you'd like, I can send you a fax back of benefits for her.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct, that'd be fantastic. Is that a breakdown of benefits for her?
[AGENT][NEUTRAL] Yeah, I'll have a full breakdown.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] Perfect. Let me get that benefit screen loaded.
[CUSTOMER][NEUTRAL] So is this policy number her is her group number?
[AGENT][NEUTRAL] No, her group number is a different number. Um, her group number is gonna be 70044.
[CUSTOMER][NEUTRAL] Is this through an employer or who is this through?
[AGENT][NEUTRAL] Yeah, it's through an employer.
[CUSTOMER][NEUTRAL] And who's is it under the workforce? let me get back in here.
[CUSTOMER][NEUTRAL] I was trying to look at things in my computer system and let me pick from list.
[CUSTOMER][NEUTRAL] 70044 you said?
[AGENT][NEUTRAL] 700448.
[CUSTOMER][NEUTRAL] Is this for like
[CUSTOMER][NEUTRAL] Mhm, is this through like American Public Life or Mega for staffing or something?
[AGENT][NEUTRAL] Um, American Public Life is our company. The Megafor staffing is the group name.
[AGENT][NEUTRAL] On file for her policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that that is a billing address of the [PII], correct?
[AGENT][POSITIVE] Oh, we actually have an updated billing address that I'd love for you to have.
[CUSTOMER][NEUTRAL] OK, let me go back out of here. It'll be let me see something. I'm gonna pick somebody else.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And what is your mailing address now?
[AGENT][NEUTRAL] Yes, it is going to be [PII], and that is going to be in [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And the zip code here is [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, let me.
[CUSTOMER][NEUTRAL] Update that.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Hold on, [PII].
[AGENT][NEUTRAL] [PII] is the city and then the state's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, like [PII].
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, and let's see, so it's [PII] I mean [PII] correct?
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] OK, and then the zip code is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and just briefly what I have on here, it looks like um her diagnostic and preventative or 100% and restorative is at 80% and there's no other coverage for like root canals, crowns, prosedontics, anything like that correct?
[AGENT][NEUTRAL] Yeah, so as far as her benefits go, she has her preventative is 100% of allowable, and then her basic expenses are 80%, but she has no major expenses, um, on this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. And what's her limit? Is it 500?
[AGENT][NEUTRAL] Yeah, mhm, yeah, it's gonna be $500 with a $50 deductible, but preventative services will not apply to our deductible.
[CUSTOMER][NEUTRAL] OK, because we have like a generic plan generated in the computer system, so I just wanted to make sure that that hadn't changed, um, so and just to recap her member ID or subscriber ID number is 02552506 correct?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][POSITIVE] OK, and yeah, so if I could get a fax of that information that'd be fantastic.
[AGENT][POSITIVE] You bet you, and what's the wonderful fax number I can send this to for you, Miss [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] perfect. [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Alright and give me a moment to get that going out to you, Miss [PII], and I do just wanna let you know um that any benefit information I give you over the phone is always just a verification of coverage and never guarantee of payment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, would you need a.
[AGENT][POSITIVE] Alright, and then it looks like I, the facts on my side looks good. It should come through for you in about 5 to 15 minutes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And is there any other information I can provide for you my friend?
[CUSTOMER][POSITIVE] No ma'am, I greatly appreciate your help thank you so much.
[AGENT][POSITIVE] Hey, it's my pleasure. Thank you for calling APL. I hope you have a fabulous day.
[CUSTOMER][POSITIVE] You as well thank you mhm bye bye.
[AGENT][POSITIVE] Thanks.