AccountId: 011433970860
ContactId: 30737646-ed29-413c-a4d9-7ba6f23158aa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 440059 ms
Total Talk Time (AGENT): 163346 ms
Total Talk Time (CUSTOMER): 112493 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/2025/02/19/30737646-ed29-413c-a4d9-7ba6f23158aa_20250219T21:17_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi [PII], this is [PII] here calling from Market Dental. I need to verify the patient's eligibility and benefit details. Uh, could you assist me regarding this?
[AGENT][NEUTRAL] OK, like you said this is for a dental policy that you're needing eligibility and benefits for, is that correct?
[CUSTOMER][POSITIVE] Yes, right. That's right.
[AGENT][NEUTRAL] Uh, yes, sir. I can help you with that, [PII], and for our dental policies, [PII], we have fact backs of the member's benefits.
[CUSTOMER][NEUTRAL] I would like to go with the verbal. I would like to go with the verbal. Could you assist me with the verbally?
[AGENT][NEUTRAL] Yes, I can do that, [PII], and what is your callback number?
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, the callback number is [PII] and the ending extension is [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number please [PII]?
[CUSTOMER][NEUTRAL] It's 614132 is the policy number.
[AGENT][NEUTRAL] 6, what is it again?
[CUSTOMER][NEUTRAL] 61
[CUSTOMER][NEUTRAL] 41
[CUSTOMER][NEUTRAL] 32
[CUSTOMER][NEUTRAL] 14132.
[AGENT][NEUTRAL] 614-132. Is that what you stated?
[CUSTOMER][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Would you go with the uh deductibles and for this patient's policy.
[AGENT][NEUTRAL] Just a moment [PII] until the information gets loaded and then I'll proceed, OK?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. One moment.
[CUSTOMER][NEUTRAL] Can I get the frequency for pre uh well.
[CUSTOMER][NEGATIVE] It also prevented.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] [PII], just a moment while the information is loading.
[AGENT][NEUTRAL] And what is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] I can see that the patient's first name is.
[CUSTOMER][NEUTRAL] Just give a minute.
[CUSTOMER][NEUTRAL] [PII] is the first name and the last name is [PII]
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. So she is the subscriber on this plan. This policy is active, effective [PII].
[AGENT][NEUTRAL] The calendar year max on this policy is $1000 for covered insured with a calendar year deductible of $50 per covered insured.
[CUSTOMER][NEUTRAL] Can I get the co insurance person your preventative basic and make.
[AGENT][NEUTRAL] This, there is no co-insurance. This plan has specific benefit benefit amounts that it pays for specific coverage services.
[AGENT][NEUTRAL] Again, all of this information is on the fax back of the complete benefits of the member's plan.
[CUSTOMER][NEUTRAL] Yeah, could you assist me with?
[CUSTOMER][NEUTRAL] OK, uh,
[CUSTOMER][NEUTRAL] Can I get the group name and group number?
[AGENT][NEUTRAL] There is no group number and there is no group name for this member's policy.
[CUSTOMER][NEUTRAL] Uh, effective date is [PII], right?
[AGENT][NEUTRAL] No, sir. [PII].
[CUSTOMER][NEUTRAL] The patient is a policyholder for this plan?
[AGENT][NEUTRAL] Yes, she is.
[CUSTOMER][NEUTRAL] Is there any waiting period? There is no waiting period, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Nothing has been nothing has been met, right?
[AGENT][NEUTRAL] For this calendar year?
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] No, sir, as of now, it has not.
[CUSTOMER][NEUTRAL] OK, is there any history for this patient's policy which affects the frequency or is any history for this year?
[AGENT][NEUTRAL] Again, you can give me the codes. I can give you dates of history of the code is on file, although the codes are on the fax side.
[CUSTOMER][NEUTRAL] Is there any, is there any
[AGENT][NEUTRAL] Again, you will give me.
[CUSTOMER][NEUTRAL] Is there any
[CUSTOMER][NEUTRAL] 0210 is there any history for 0210?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] No, there is not.
[CUSTOMER][NEUTRAL] Uh is an ST4 0150 or 01200040.
[AGENT][NEUTRAL] I'm sorry. OK, you'll have to give me each code one at a time. What was the next code after 0210?
[CUSTOMER][NEUTRAL] 0330.
[AGENT][NEUTRAL] 0330. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 72
[CUSTOMER][NEUTRAL] Is an issue for wide wings?
[AGENT][NEUTRAL] Data service 729 and 14.
[CUSTOMER][NEUTRAL] White wings.
[AGENT][NEUTRAL] Code number?
[CUSTOMER][NEUTRAL] 0272.
[AGENT][NEUTRAL] 723 2007.
[CUSTOMER][NEUTRAL] There is no history for FMX and panel, right?
[AGENT][NEUTRAL] What is the code?
[CUSTOMER][NEUTRAL] 0210 and 0330.
[AGENT][NEUTRAL] I'm sorry. We already did this again. OK, give me the codes again. Are those the two that I just did for you?
[CUSTOMER][NEUTRAL] 0210.
[AGENT][NEUTRAL] Yes, sir, I told you there was no history on file for that one, [PII].
[CUSTOMER][NEUTRAL] Is there any history for 4910?
[AGENT][NEUTRAL] No history?
[CUSTOMER][NEUTRAL] OK, if you don't mind, may I have your name and call reference number?
[AGENT][NEUTRAL] Again, my name is [PII] and you would use my name along with today's date as your call reference number and if you do file a claim with APO for this number once our claim has been processed, you may check the claim status and have access to our explanation of benefits by going to [PII].
[CUSTOMER][POSITIVE] Thank you, [PII]. Thank you for providing information.
[AGENT][POSITIVE] You're very welcome. Yes. And is there anything else I can help you with today, [PII]?
[CUSTOMER][POSITIVE] I think thank you for providing valuable information. Have a nice day.
[AGENT][POSITIVE] You too and thank you again for calling APL.
[AGENT][NEUTRAL] Bye bye.