AccountId: 011433970860
ContactId: 15f1c896-fde6-4881-92ba-9d3c0d65d95b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 623369 ms
Total Talk Time (AGENT): 160009 ms
Total Talk Time (CUSTOMER): 182971 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/15f1c896-fde6-4881-92ba-9d3c0d65d95b_20250416T20:51_UTC.wav
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[AGENT][POSITIVE] Thank you for calling HBL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, I am [PII] calling on behalf of the dental provider's office to check the benefits of a patient on a recorded line. Uh, could you please help me with that?
[AGENT][POSITIVE] Yeah, I could check benefits for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, it's [PII]. And can I get your name, please?
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][POSITIVE] Mhm. Thank you so much, [PII], for that.
[AGENT][NEUTRAL] Of course, and then do you have that policy number, [PII]?
[CUSTOMER][NEUTRAL] Yes, I just got the ID number as 02579759.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Mhm. Patient is.
[CUSTOMER][NEUTRAL] [PII]. Date of birth, [PII].
[CUSTOMER][NEUTRAL] Sorry, [PII].
[AGENT][NEUTRAL] OK, thank you for that. Alrighty, um, so of course this policy is active. Effective date was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And if you'd like I can send you a fax back that has all of the covered procedures and benefit information.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, got it. Is it a PPO plan or an HMO plan?
[AGENT][NEUTRAL] No, so this plan, uh, pays off of, uh, based off of UCR.
[AGENT][NEUTRAL] So there's no network.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] So there is no network for the plan.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, I got it, uh, [PII]. And is it a calendar year or fiscal year plan?
[AGENT][NEUTRAL] It is a calendar year plan.
[CUSTOMER][NEUTRAL] Mhm. Uh, what will be the co-insurances for preventative basic and major?
[AGENT][NEUTRAL] Yes, so pre uh preventative is at 100% of UCR.
[AGENT][NEUTRAL] Radiographs, FMX, and basic expenses are at 80%.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Major antiontic, uh, periodontic, prosthodontic, and oral surgery are all at 40%.
[CUSTOMER][NEUTRAL] OK. So can I get the annual maximum and deductible value? Is anything used and is there any history?
[AGENT][NEUTRAL] Of course, of course I will let you know verification of coverage is not a guarantee of payment for claims. The calendar year maximum is $1500 per covered insured.
[AGENT][NEUTRAL] Calendar year deductible is $50 per covered insured up to $150 per family, and the deductible does not apply to preventative expenses, and if you'll give me one moment I'll see if we have any history for this member and if anything has been used.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] OK, so nothing has been used so far this year and I have no history for this member.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, what would be the group number and name?
[AGENT][NEUTRAL] Oh sure one moment.
[AGENT][NEUTRAL] Uh, group number is 16068.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK and then that group name is Universal.
[AGENT][NEUTRAL] Trucking
[AGENT][NEUTRAL] And then whenever you're ready I'm going to spell the last uh.
[AGENT][NEUTRAL] Part for you.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, so that's H as in hotel?
[AGENT][NEUTRAL] I as in India,
[AGENT][NEUTRAL] R as in Romeo.
[AGENT][NEUTRAL] S as in Sierra,
[AGENT][NEUTRAL] C as in Charlie,
[AGENT][NEUTRAL] H as in hotel.
[AGENT][POSITIVE] B as in Bravo.
[AGENT][NEUTRAL] A as in Alpha.
[AGENT][NEUTRAL] C as in Charlie, H as in Hotel.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. It's universal tracking Ibaka.
[AGENT][NEUTRAL] I'm not sure how it's pronounced, but yes.
[CUSTOMER][NEUTRAL] Yeah, yeah, I got it. No problem in that, Kara. And there is no history, right? As you said, so there is no any, any histories on the file.
[AGENT][NEUTRAL] Correct, correct, as the policy, yes, uh, the policy was just, uh, effective, of [PII] of this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Mhm. I got it. Thank you so much. And [PII], actually, I just got only some few procedure codes. Uh, I just want your percentage and sequency, that's enough for me. Could you please help me with those?
[AGENT][NEUTRAL] Um, really quick, actually, did you want me to go ahead and send you this fax back that has all of that information on there?
[CUSTOMER][NEUTRAL] Uh, yes, but actually, I, I have some uh difficulties in receiving facts. That's why I just made a call.
[AGENT][NEUTRAL] Oh, I see. OK, um, let's see, yes, uh, what were those codes?
[CUSTOMER][NEUTRAL] Mhm. No.
[CUSTOMER][NEUTRAL] Mhm. Um, I just want your percentage frequency and age limit. That's enough for me. Um, it will be 0150.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 0120.
[CUSTOMER][NEUTRAL] 0140.
[CUSTOMER][NEUTRAL] 0145.
[CUSTOMER][NEUTRAL] 1206
[CUSTOMER][NEUTRAL] 11 1
[CUSTOMER][NEUTRAL] 11:20
[CUSTOMER][NEUTRAL] 1351.
[CUSTOMER][NEUTRAL] 1353
[CUSTOMER][NEUTRAL] 0210.
[CUSTOMER][NEUTRAL] 0330.
[CUSTOMER][NEUTRAL] 0220
[CUSTOMER][NEUTRAL] 074
[AGENT][POSITIVE] I'm sorry, it kinda, I'm so sorry [PII] that last one.
[CUSTOMER][NEUTRAL] 2140
[CUSTOMER][NEUTRAL] 2330.
[AGENT][NEUTRAL] Could you repeat the one prior to that? Uh, it kind of cut out there.
[CUSTOMER][NEUTRAL] Uh, so, so which code 0274, are you clear, still that?
[AGENT][NEUTRAL] [PII] OK that was the one thank you go ahead.
[CUSTOMER][NEUTRAL] Mhm. 2140.
[CUSTOMER][NEUTRAL] 2330.
[CUSTOMER][NEUTRAL] 7111.
[CUSTOMER][NEUTRAL] 7140.
[CUSTOMER][NEUTRAL] 7210.
[CUSTOMER][NEUTRAL] 9230.
[CUSTOMER][NEUTRAL] 9248.
[CUSTOMER][NEUTRAL] 9222.
[CUSTOMER][NEUTRAL] 2010.
[AGENT][NEUTRAL] I'm sorry, could you repeat that one, [PII]? It cut out again. I'm sorry.
[CUSTOMER][NEUTRAL] 2740.
[CUSTOMER][NEUTRAL] 27
[CUSTOMER][NEUTRAL] Yes. Mhm. No problem. [PII] 2710.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] 2740, 2740. 2790.
[CUSTOMER][NEUTRAL] 2930.
[CUSTOMER][NEUTRAL] 293 1
[CUSTOMER][NEUTRAL] 2934.
[CUSTOMER][NEUTRAL] 9310.
[CUSTOMER][NEUTRAL] 4355
[CUSTOMER][NEUTRAL] 9944.
[CUSTOMER][NEUTRAL] And the last one is 9951.
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], are you there?
[CUSTOMER][NEUTRAL] Hello.