AccountId: 011433970860
ContactId: 27167b58-6b6d-4f67-a04f-640f55a0fe25
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 465359 ms
Total Talk Time (AGENT): 142414 ms
Total Talk Time (CUSTOMER): 169914 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/27167b58-6b6d-4f67-a04f-640f55a0fe25_20250523T20:16_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, good afternoon, [PII]. This is [PII] from Dental provider office. Hope you will be good. And yes, I have patients with 4 questions regarding eligibility and benefits.
[AGENT][NEUTRAL] OK, you have 4 you said you have 4 questions.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] A single
[CUSTOMER][NEUTRAL] Yes, single patient with your queries only.
[AGENT][NEUTRAL] OK, can you
[AGENT][NEUTRAL] I understand. Hold on one moment. Can you repeat your name for me, please? I couldn't understand you.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, ma'am. It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] Remember policy number 0257.
[CUSTOMER][NEUTRAL] 64652 02574652.
[AGENT][NEUTRAL] Thank you. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, member name is [PII], but my patient is [PII], with the name of, uh, with the date of birth [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And what questions did you have today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] First of all, would you please let me know about provider participation and provide in network or are gonna be out of network?
[AGENT][NEUTRAL] I'm sorry, can you speak slowly? Can you repeat that, please?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Would you please let me know my provider is in-network or out of network?
[AGENT][NEUTRAL] Um, this policy does not have a network.
[CUSTOMER][POSITIVE] OK, perfect. That's so simple. And would you please uh let me know about group number and group name?
[AGENT][NEUTRAL] Sure, the group number is 14564.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the group name is Universal.
[AGENT][NEUTRAL] Trucking
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] Anderson
[AGENT][NEUTRAL] Flatbed.
[CUSTOMER][NEUTRAL] A [PII]. Am I right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK. Thank you so much. Let me document it, please bear with me.
[CUSTOMER][NEUTRAL] Please bear with me.
[CUSTOMER][NEUTRAL] Yes, I'm done with this. Would you please provide me deduct, deductibles, and annual deductibles?
[AGENT][NEUTRAL] The yearly and the annual
[AGENT][NEUTRAL] The calendar year max is $1500 per covered person and the deductible is $50 per person up to $150 per family.
[CUSTOMER][NEUTRAL] And it
[CUSTOMER][NEUTRAL] Any uh anything made from deductibles?
[AGENT][NEUTRAL] And it doesn't
[AGENT][NEUTRAL] Go ahead. I'm sorry.
[CUSTOMER][NEUTRAL] Anything used from deductible or maximum?
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] And you said your patient was [PII]?
[CUSTOMER][POSITIVE] Yes, [PII].
[AGENT][NEUTRAL] She's, let me see, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] She's used $553.
[AGENT][NEUTRAL] She has $947 left for the year.
[CUSTOMER][NEUTRAL] 947.
[CUSTOMER][NEUTRAL] And the deductible has been met or not?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Already made. Perfect. Thank you so much.
[CUSTOMER][NEUTRAL] And uh yes. Would you please let me know is there any pending claim?
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Um, no, there's no pending claims on file for [PII].
[CUSTOMER][NEUTRAL] OK. Extraction history for doth number 17 and 32.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Is there any extraction history for the number 17 and 32?
[CUSTOMER][NEUTRAL] Extraction history for tooth number 1717 and 3232.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Do you have any codes for the extraction? I can't search by tooth number.
[CUSTOMER][NEUTRAL] Uh, ma'am, uh, all 7000 frees code like 714,072,107,220. Any 7,0003 codes, all are for exception, any extension code for tooth number 17 and tooth number 32.
[AGENT][NEUTRAL] OK, um, that's not how we search. I'll, I'll try. Hold on one moment.
[CUSTOMER][NEUTRAL] OK. I can provide you 1111 code. 7140.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm. 7140.
[AGENT][NEUTRAL] There's no um claims or history on file for 07140.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh 7210?
[AGENT][NEUTRAL] There's no claims on file?
[CUSTOMER][NEUTRAL] 7230
[AGENT][NEUTRAL] Um, there's no claims on file.
[CUSTOMER][NEUTRAL] 7220
[AGENT][NEUTRAL] No claims?
[CUSTOMER][NEUTRAL] 7240
[AGENT][NEUTRAL] There's no claims?
[CUSTOMER][NEUTRAL] 7241
[AGENT][NEUTRAL] There's no claims on file?
[CUSTOMER][NEUTRAL] 725051.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] We haven't processed that many claims for her, so I'll just go through the claims that we have and see what was processed.
[CUSTOMER][NEUTRAL] I'm sorry, what did you say?
[AGENT][NEUTRAL] We haven't processed many claims for her, so I can go through each of the claims to see what has been um used and what's been processed.
[CUSTOMER][NEUTRAL] Mm mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And there's no claims on file for extractions.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much. Would you please provide me a reference number, uh, and spell for your name first and then reference number?
[AGENT][NEUTRAL] There's no call reference number, but you can use my name in today's date, which is [PII] The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, [PII], thank you so much. uh, stay blessed. Have a good day. Bye-bye for now.
[AGENT][POSITIVE] Have a good day and thanks for calling APL Roy. I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You too. Bye-bye for now.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] On
[CUSTOMER][NEUTRAL] What's that about?
[CUSTOMER][NEUTRAL] Of a phone.