AccountId: 011433970860
ContactId: 19e345dd-3ae0-43d5-83ab-b753d45c9846
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218350 ms
Total Talk Time (AGENT): 105643 ms
Total Talk Time (CUSTOMER): 90981 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/19e345dd-3ae0-43d5-83ab-b753d45c9846_20250512T15:38_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I needed to verify coverage for uh dental, please.
[AGENT][NEUTRAL] OK, and your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII], what's the policy number?
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] 6071777
[AGENT][NEUTRAL] OK, and you said you're verifying eligibility dates?
[CUSTOMER][POSITIVE] And benefits for one of your members, yes.
[AGENT][NEUTRAL] OK, is this for service in an office or outpatient facility?
[CUSTOMER][NEUTRAL] I'm calling from a dental office.
[AGENT][NEUTRAL] Dental. OK. And what's the phone number, [PII], in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Would you like to schedule a benefits faxed to you?
[CUSTOMER][NEUTRAL] Um, before doing that, I just have some questions in regards to the plan.
[AGENT][NEUTRAL] OK. What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[CUSTOMER][NEUTRAL] You can tell the 12.
[AGENT][NEUTRAL] OK, if it's several questions regarding procedure codes, we'll need to get that faxed over to you. Um, I'm showing an effective date of [PII]. I show the policy is active at this time. There's a $1500 calendar year maximum per covered person, and then a $50 calendar year deductible that applies towards the basic and major services.
[AGENT][NEUTRAL] What other questions did you have?
[CUSTOMER][NEUTRAL] Yeah, can you tell me where to send our claims to and their group number?
[AGENT][NEUTRAL] The claim mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] And the group number is 13611.
[CUSTOMER][NEUTRAL] What is the group name on this plan please?
[AGENT][NEUTRAL] Universal Trucking.
[AGENT][NEUTRAL] That information I believe is on the ID card as well.
[CUSTOMER][NEUTRAL] OK, 73124 is this um PPO plan?
[AGENT][NEUTRAL] So it, it's not a network affiliated with this particular policy.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What plan fee schedule do we follow on this plan?
[AGENT][NEUTRAL] This is based on UCR.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, yeah, I know, but um.
[CUSTOMER][NEUTRAL] My question is, oh, is it's a UCR plan fee schedule?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So this plan only covers 100% for X-ray and exam and for single rows and any major work is 40% for 0, am I correct?
[AGENT][NEUTRAL] Preventive 100% basic or restorative services 80% major is 40% of UCR mhm.
[CUSTOMER][NEUTRAL] A, uh-huh.
[CUSTOMER][POSITIVE] OK, yeah, I got it.
[CUSTOMER][NEUTRAL] And there's no waiting period.
[AGENT][NEUTRAL] Um, there
[AGENT][NEUTRAL] There is a 12 month waiting period for major services, so they will not be eligible until [PII] for major.
[CUSTOMER][NEUTRAL] OK, so 12 months late.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and your, uh, can I get your first name please?
[AGENT][NEUTRAL] You'll use my name in today's date is your reference, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] ONYA first initial last is [PII] and any other questions, [PII], I can help out with today?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] All right. Well, thank you for calling AP. You're welcome. Thanks for calling APL. Have a good day. Bye-bye.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Mm bye.