AccountId: 011433970860
ContactId: 20462b7c-80e4-44d8-a390-7fce36c5bb07
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 347940 ms
Total Talk Time (AGENT): 130852 ms
Total Talk Time (CUSTOMER): 114408 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/20462b7c-80e4-44d8-a390-7fce36c5bb07_20250411T15:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello ma'am, I'm calling from Thompson Dental Wellness. My name is [PII]. I'm just trying to, uh, verify benefits for one of our patients.
[AGENT][NEUTRAL] May I please have a callback number and then the policy number?
[CUSTOMER][NEUTRAL] Of course callback number is [PII] policy number 02457221.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Name is [PII], last name [PII], [PII]
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] And thank you so much [PII] for verifying the policy. You're calling in for eligibility for this not for benefits for this member. Would you like for me to submit you a fax back?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK, may I have a fax number please?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And that's to the attention of [PII]?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK. May I have the correct spelling of your name, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is [PII]
[AGENT][POSITIVE] OK, I you're right. OK, is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Um, do you possibly have this patient's account number? I am trying to at least sign us up on the online portal.
[AGENT][NEUTRAL] The patient account number will be the number that you all assigned to the member.
[CUSTOMER][NEUTRAL] That we assigned to the member.
[AGENT][NEUTRAL] Yes, that's what the patient account number is.
[CUSTOMER][NEUTRAL] So it's.
[CUSTOMER][NEUTRAL] OK, so it's like our um.
[CUSTOMER][NEUTRAL] The ID number in our software correct?
[AGENT][NEUTRAL] Whatever account number that it assigned to the patient for that date of service, that's considered the patient's account number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it's possible that you can't set up.
[AGENT][NEUTRAL] The account until a claim has been submitted if it's requiring the patient account number to set it up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Does it give you another option in the place of the patients account number?
[CUSTOMER][NEUTRAL] I just
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] OK, so yes, that would be the only way that if you've submitted a claim previously, then you would be able to.
[AGENT][NEUTRAL] Sign in.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] Yeah, I do.
[AGENT][NEUTRAL] But I didn't think you had to have that just to set up a user, the account. I didn't think you had to have that to set the account up.
[AGENT][NEUTRAL] Let me check that for you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Yes, so that is what it's looking like. You would have to submit a claim in first and then you would either choose if it was a UB04 or if it's the ADA, it would be shown in box 23 for that patient account number.
[CUSTOMER][POSITIVE] Exactly.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] So I'll go ahead.
[CUSTOMER][NEUTRAL] All right, so I'll just wait until we submit for this patient. I do have a few quick questions about her plan while waiting for the fact.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, what is her maximum for this year?
[AGENT][NEUTRAL] Let me pull that up for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And for this member, you're welcome. verification of coverage does not guarantee the payment of the claim. The member has up to $500 per calendar year, and they do have a $50 year deductible, but that does not apply to the preventative services.
[CUSTOMER][NEUTRAL] All right and do preventative services apply to the maximum?
[AGENT][NEUTRAL] Yes. On, no, no, no, no, I apologize. No, for the preventative services, they do have up to a separate covered expense.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh OK
[CUSTOMER][NEUTRAL] So it is fully separate.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][NEUTRAL] You're welcome. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][POSITIVE] OK, and I'm getting it fax submitted over to you. I do wanna thank you for calling American Public Life. Have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm