AccountId: 011433970860
ContactId: 1551a5f0-7050-43b0-b7c8-73e2923c4bc2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 294619 ms
Total Talk Time (AGENT): 107385 ms
Total Talk Time (CUSTOMER): 126808 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/1551a5f0-7050-43b0-b7c8-73e2923c4bc2_20250527T19:38_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII]. I work for a provider's office. Um, I've never, um, put in you guys into our system, so I was just calling to see if my provider is in network and if he's not, if this patient has out of network benefits for dental.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. And Ms. [PII], do you have a policy number?
[CUSTOMER][NEUTRAL] I do. It's 025996743.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] It's not one of our policy numbers. Yeah, the patient's name, date of birth?
[CUSTOMER][NEUTRAL] I do. Um, I have the patient and also I have the subscriber. Which one would you prefer?
[AGENT][NEUTRAL] Uh, you can get the patient.
[CUSTOMER][NEUTRAL] OK. Her name is [PII]
[CUSTOMER][NEUTRAL] Last name is [PII]
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] I don't show her in the system. What's the policyholder's name?
[CUSTOMER][NEUTRAL] His name is [PII]
[CUSTOMER][NEUTRAL] And his date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like the policy number you gave me could be correct. It just has an extra 9.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So 999.
[AGENT][NEUTRAL] Uh, no, it's, no, you have an extra 9 on what you gave me. It's 259-674-3.
[CUSTOMER][NEGATIVE] Oh, I haven't OK.
[CUSTOMER][NEUTRAL] Got you, OK.
[AGENT][NEUTRAL] This is for [PII]. OK, so her effective date is [PII] and she is active. And you say you're inquiring about a breakdown of benefits for dental?
[CUSTOMER][NEUTRAL] Yes, well, we're code specific. I just need to know first off if if we're in network or not and if not, um, if she has dental out of network benefits.
[AGENT][NEUTRAL] Well, her policy she has is open, so we don't have a network. They can go to any dental provider.
[CUSTOMER][NEUTRAL] So is it like a discount card?
[AGENT][NEUTRAL] Uh, no, not really. I mean, it's a dental policy, but it's just a limited dental plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So they can go anywhere they want.
[AGENT][NEUTRAL] Yes, ma'am, and we do take assignments.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, um, yeah, let me just, um, get her deductible max if anything's been met, and can you do code specific codes to tell me what they're covered at?
[AGENT][NEUTRAL] Mhm. Sure. But I can also send you a fax back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Will it have all codes, all ADA codes on it?
[AGENT][NEUTRAL] Yes, ma'am. All codes that are covered. Um, I will let you know with this policy, it doesn't cover any uh major services and that will include endoerio and oral.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, what's your fax number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] And mhm.
[CUSTOMER][NEUTRAL] Yes, and will her name be on it?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And do you have a callback number in case um there's any issues with it? OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][POSITIVE] OK, thank you, ma'am. And is there anything else, Ms. [PII], I can assist you with today?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Will it have the deductible and max and the accumulation on it?
[AGENT][NEUTRAL] Uh, yes, ma'am. And it will also have the frequencies and limitations as well.
[CUSTOMER][POSITIVE] Sweet, wonderful, thank you, [PII]. I appreciate it. Can I get a reference number?
[AGENT][NEUTRAL] Uh, if you like, you may use my name in today's date.
[CUSTOMER][POSITIVE] OK, thank you so much. I hope you have a good rest of your day.
[AGENT][POSITIVE] Oh, you too. Thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you. Alright, bye bye.
[AGENT][NEUTRAL] Bye.