AccountId: 011433970860
ContactId: 168ef777-c2a2-459e-9459-d889b245eb6e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229440 ms
Total Talk Time (AGENT): 97904 ms
Total Talk Time (CUSTOMER): 77417 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/168ef777-c2a2-459e-9459-d889b245eb6e_20250103T14:33_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] Yes, hi, [PII]. My name is [PII] and I'm calling to confirm um eligibility and benefits for a member.
[AGENT][NEUTRAL] OK, well, I can help you with both the eligibility and benefits, and [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes, of course. So you can reach me through [PII].
[AGENT][NEUTRAL] And then the policy number whenever you're ready.
[CUSTOMER][NEUTRAL] Yes. So policy number 2255.
[CUSTOMER][NEUTRAL] 430.
[AGENT][NEUTRAL] 430.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, hold on one moment. Thank you for that.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] First and last name is [PII]. The uh date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And did you need a copy of the fax back or you have particular questions about it?
[CUSTOMER][NEUTRAL] Yes, I do have particular questions. So, um, does this plan have a family deductible?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, um, so the the deductible is up to $50 per person, um, well, $50 per person up to $150 per family, but this is an individual policy.
[CUSTOMER][NEUTRAL] Oh, individual. OK, I see. And I just need like, um,
[CUSTOMER][NEUTRAL] Uh, two codes in particular, 2620 and 2630, if they're covered in the percentage.
[AGENT][NEUTRAL] OK. You said 26, 20 and 2630, right?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, let me see, hold on one moment.
[AGENT][NEUTRAL] So, yes, they're both under major, um, and let me see if there's any.
[AGENT][NEUTRAL] So majors covered that 40%, and let me see if there's any exclusions or anything.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And it has maximum of 1 per 7-year period and limited to patients aged [PII]/16 and over for both codes.
[CUSTOMER][POSITIVE] OK awesome.
[CUSTOMER][NEUTRAL] Uh, 7 years. And, uh, for dentures, that's also 7 years. And um is there implants covered for this plan?
[AGENT][NEUTRAL] Um, implant placement, removal and all related services are not covered. Dentures and partials are once every 5 years.
[CUSTOMER][POSITIVE] Every 5. OK. Awesome. All right. I think I'm all good and all set. I just need the reference number for the call, [PII]na.
[AGENT][NEUTRAL] OK, so there's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII] in Larry.
[CUSTOMER][POSITIVE] Awesome. All right. Thank you so much for your assistance today. You have a lovely day.
[AGENT][POSITIVE] Thank you, Melinda. You also, and thanks for calling APL and happy New Year.
[CUSTOMER][POSITIVE] Happy New Year, bye.
[AGENT][POSITIVE] Thank you, bye bye.