AccountId: 011433970860
ContactId: 12563853-7773-46a8-8190-d3d55de3a994
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 605679 ms
Total Talk Time (AGENT): 188026 ms
Total Talk Time (CUSTOMER): 287110 ms
Interruptions: 7
Overall Sentiment: AGENT=1.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/12563853-7773-46a8-8190-d3d55de3a994_20250115T16:17_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling because I'm trying to get uh.
[CUSTOMER][POSITIVE] Benefits, uh, breakdown from my patient if you can help me with that please.
[AGENT][POSITIVE] OK, I'll be more than happy to assist you with the benefits and can you repeat your name for me, please?
[CUSTOMER][NEUTRAL] Hey [PII].
[AGENT][NEUTRAL] And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes, that would be 7709635999. Mm.
[AGENT][NEUTRAL] Thank you for that and the member's policy number?
[CUSTOMER][NEUTRAL] That will be 02559901.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII], date of birth [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And did you need a copy of the fax back sent over, you had questions?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] I know she ain't she ain't got shit.
[CUSTOMER][NEUTRAL] Uh, it is possible if I can get the breakdown of the phone.
[AGENT][NEUTRAL] Sure, I can go over the facts that with you. Um, let me know when you're ready.
[CUSTOMER][NEUTRAL] Yes, just started, um, can you please tell me the, please get your name on this policy.
[AGENT][NEUTRAL] Um, so this is a standard fee schedule?
[CUSTOMER][NEUTRAL] Standard fee schedule.
[CUSTOMER][NEUTRAL] Hi how may I.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, give me one sec.
[CUSTOMER][NEUTRAL] OK, I'm gonna transfer you right now.
[CUSTOMER][NEUTRAL] Give me 1 2nd.
[CUSTOMER][NEUTRAL] And can you please provide me with the PO box?
[AGENT][NEUTRAL] Um, so our claims mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] She
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, give me one second.
[CUSTOMER][NEUTRAL] You say [PII], right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Give me one second, alrighty, and when this policy became effective?
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] The policy has been active since [PII].
[CUSTOMER][POSITIVE] Perfect and can you please tell me the group number?
[AGENT][NEUTRAL] It is.
[AGENT][NEUTRAL] 70055
[CUSTOMER][NEUTRAL] 70055
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And the group name?
[AGENT][NEUTRAL] It's T as in Tom, R like Robert, C like cat.
[AGENT][NEUTRAL] Staffing services.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Senator
[CUSTOMER][POSITIVE] Fresh
[CUSTOMER][NEUTRAL] I'm sorry, what was it?
[AGENT][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] So it's TRC Staffing Services.
[CUSTOMER][NEUTRAL] Can you spell out the.
[AGENT][NEUTRAL] Staffing, S as in Sam, T like Tom, A like apple.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] F like Frank
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] F like Frank
[AGENT][POSITIVE] I like ice, N like Nancy, and G like girl.
[CUSTOMER][NEUTRAL] Did you, so what did you make?
[CUSTOMER][POSITIVE] Hello, how are you today? Service perfect. And also can you please provide me with the priority.
[AGENT][NEUTRAL] Yes, it's 60801.
[CUSTOMER][NEUTRAL] A.
[CUSTOMER][POSITIVE] Perfect, let me see what else.
[CUSTOMER][POSITIVE] Perfect, uh, can you please tell me the coverage max for this policy?
[AGENT][NEUTRAL] For the calendar year, the maximum is $1500.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] There's a
[CUSTOMER][NEGATIVE] Nothing has been used.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] F
[AGENT][NEUTRAL] Hold on one second.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] And your questioning
[CUSTOMER][NEUTRAL] right
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] With you.
[AGENT][NEUTRAL] OK, this is the, hold on one moment.
[CUSTOMER][NEUTRAL] to bring that in the hearing.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] They talk about being a professional and highly trained.
[AGENT][NEUTRAL] OK, so the calendar year max, my apologies, is $500 per year.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEGATIVE] None has been used.
[CUSTOMER][NEUTRAL] So it's not 1500, it's 500?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, that's 500 perfect.
[CUSTOMER][NEGATIVE] Nothing has been used.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Perfect. And can you please tell me the individual uh deductible and family?
[AGENT][NEUTRAL] Um, there's a $50 deductible up to $150 per family.
[CUSTOMER][NEUTRAL] 250 for family. Perfect. Um, can you please tell me is deductible applies for basic major?
[AGENT][NEUTRAL] Well, the policy doesn't cover major, um, but yes, deductible, um, is applied to basic.
[CUSTOMER][NEUTRAL] OK, perfect. Can you please tell me the percentage for preventive diagnostic basic major period and the.
[CUSTOMER][NEUTRAL] Oral crowns and implants?
[AGENT][NEUTRAL] So preventative is covered at 100%?
[AGENT][NEUTRAL] Radio graphs.
[AGENT][NEUTRAL] Um, an FMX basic expenses and basic restorative are all covered at 80.
[AGENT][NEUTRAL] This policy this policy doesn't cover major um services which includes endodontic, periodontic, prosodontic, and oral surgery.
[CUSTOMER][NEUTRAL] OK, what about crowns and implants?
[AGENT][NEUTRAL] Um, that's all major.
[CUSTOMER][NEUTRAL] That's so it's not covered as well. OK, so period and the oral crowns and implants are not covered.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, so under major it's um periodontic, prosodontic.
[AGENT][NEUTRAL] Endoonic and all oral surgery codes.
[CUSTOMER][NEUTRAL] Got it. Uh, let's see what else do I need? OK, that will be all that I need. Uh, can you please tell me all the breakdown and how much the insurance covered through fax if it is possible.
[AGENT][NEUTRAL] Sure, what's a good fax number for you?
[CUSTOMER][NEUTRAL] That would be [PII].
[AGENT][NEUTRAL] And do I need to put, um, hold on one moment. Can you spell your first name for me, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Oh, [PII], OK. And that was fax number [PII]?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] Alright, I'll go ahead and fax the fax back over to you now, [PII]. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] No, that will be all. Thank you so much for your help.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL. I hope you have a great day and happy New Year.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] You're welcome bye bye.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, before I let you go, uh.
[CUSTOMER][NEUTRAL] You still there?
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] OK, uh, what's the insurance name?
[AGENT][NEUTRAL] This is American Public Life.
[CUSTOMER][NEUTRAL] American public. OK, American.
[CUSTOMER][NEUTRAL] American Public Life, right?
[AGENT][POSITIVE] Mhm. That's correct.
[CUSTOMER][POSITIVE] alrighty perfect that will be all thank you so much.
[AGENT][POSITIVE] You're very welcome. Well, thanks for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.