AccountId: 011433970860
ContactId: 22ea9da7-5dbd-445f-8cb9-b87945894e11
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 199639 ms
Total Talk Time (AGENT): 91309 ms
Total Talk Time (CUSTOMER): 64985 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/22ea9da7-5dbd-445f-8cb9-b87945894e11_20250402T13:33_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes, my name is [PII]. I'm calling with Spencer and Lakes Oral Surgery, and I'm looking to get some benefits on a patient.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have the spelling of your name and a callback number for you?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] Oh sorry, I just got out of that.
[CUSTOMER][NEUTRAL] The 2nd.
[CUSTOMER][NEUTRAL] I have 02605099.
[AGENT][NEUTRAL] Thank you. Could you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you, you're welcome.
[AGENT][NEUTRAL] Thank you. You're calling to verify benefits and eligibility. This member's policy has been active since [PII] and is currently active.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And then um.
[CUSTOMER][NEUTRAL] What are the dental benefits on this? Is there a deductible and maximum?
[AGENT][NEUTRAL] So the yearly max is $500 per calendar year with a $50 deductible per insured up to $150 per family, and this is not a guarantee of benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK, what are preventative basic and major covered at?
[AGENT][NEUTRAL] Major is not covered under the policy. The policy only covers preventative at 100% and basic at 80. Major, endoperoprosthesis or surgery, crowns, bridges, ortho.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Carryo endo, none of that is covered under the policy.
[CUSTOMER][NEUTRAL] OK, and I apologize, did you say this was a calendar year plan?
[AGENT][NEUTRAL] Yes, from January to December.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, perfect. Is there any frequencies on exams or um panorex?
[AGENT][NEUTRAL] So, trophies and cleaners are once every 6 months, or evaluations are 2 for 12 month period, bit wings are once per 12 month period, and full mouth X-rays and panoramics is once every 5 years.
[AGENT][NEUTRAL] And I can send you a fax back of this information if you would like.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] Uh, that would be great. And then do you have a claims mailing address?
[AGENT][NEUTRAL] Yes, it is listed on the information that I'm gonna fax over to you. However, it's [PII]. It's [PII]. What is your fax number?
[CUSTOMER][POSITIVE] You have a good day.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] So that's [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEGATIVE] Nope, I don't believe so.
[AGENT][POSITIVE] Thanks for calling APL and have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thanks goodbye.