AccountId: 011433970860
ContactId: 230975e5-5ce3-40a7-9f20-f6ccacd47976
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226309 ms
Total Talk Time (AGENT): 71343 ms
Total Talk Time (CUSTOMER): 81730 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/230975e5-5ce3-40a7-9f20-f6ccacd47976_20250407T19:38_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. I'm calling from doctor's office. My name is [PII], and I was trying to do, um, uh, get a breakdown of uh benefits eligibility.
[AGENT][NEUTRAL] OK, do you have a phone number in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yes, the phone number is [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Uh, it is 02221162.
[AGENT][NEUTRAL] Thank you, [PII], hold on one moment please.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, [PII], and you were just needing benefits?
[CUSTOMER][NEUTRAL] Uh, I needed the breakdown of benefits and eligibility to make sure they're still covered by you guys.
[AGENT][POSITIVE] OK, I can help you with that.
[AGENT][NEUTRAL] Do you want the benefits over the phone or would you like a fax back?
[CUSTOMER][NEUTRAL] Uh, I would need both, uh, for our records and stuff, but patience and care.
[AGENT][NEUTRAL] OK, the effective date is [PII].
[AGENT][NEUTRAL] Any benefits given over the phone is not a guarantee of payment?
[AGENT][NEUTRAL] They have a $1500 calendar year maximum.
[AGENT][NEUTRAL] $50 deductible on everything except for preventative.
[AGENT][NEUTRAL] Prevented is paid at 100% of usual and customary rate.
[AGENT][NEUTRAL] Basic is paid at 80%.
[AGENT][NEUTRAL] And major is paid at 40%.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And for the max and deductible, has it been met or has anything been used for that, uh.
[CUSTOMER][NEUTRAL] 1500?
[AGENT][NEUTRAL] Not for this year. No, ma'am.
[CUSTOMER][POSITIVE] Perfect. Is there a waiting uh waiting period or missing tooth cloth?
[AGENT][NEUTRAL] There is no waiting period. There is a missing two cloth.
[CUSTOMER][NEUTRAL] And it's just uh the basic uh you guys don't cover any teeth before that were missing before the plan started, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And do you guys downgrade um Crown?
[AGENT][NEUTRAL] We do not downgrade on anything.
[CUSTOMER][NEUTRAL] OK, no downgrade. OK, that is everything. I, I can get a fax of this information for, uh, us and the patient.
[AGENT][NEUTRAL] OK, what's the fax number?
[CUSTOMER][NEUTRAL] It is gonna be [PII].
[AGENT][NEUTRAL] OK, I'll fax that to you. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Can I get a um reference number for this call?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] OK, and what was your name? I missed it at the beginning.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] [PII]. OK, perfect. Well, I hope you have a great day.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you, [PII], for calling APL you as well.
[CUSTOMER][NEUTRAL] Mhm bye bye.
[AGENT][NEUTRAL] Bye bye.