AccountId: 011433970860
ContactId: 33814980-b87e-4d1d-bd63-e031867aa359
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 346940 ms
Total Talk Time (AGENT): 108812 ms
Total Talk Time (CUSTOMER): 95670 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/33814980-b87e-4d1d-bd63-e031867aa359_20250328T15:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], my name is [PII]. I'm calling from Market Dental. How are you doing today?
[AGENT][NEUTRAL] Good, [PII]. How are you?
[CUSTOMER][POSITIVE] Yes, I'm doing great. Yes, I'm calling to verify the eligibility and benefits for the patient. Could you please help me with that?
[AGENT][POSITIVE] Happy to check on benefits and eligibility. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] the patient policy number is 614283.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. So the patient is active. Effective date is [PII].
[CUSTOMER][NEUTRAL] [PII] or 719?
[AGENT][NEUTRAL] 7101.
[CUSTOMER][NEUTRAL] And 1
[CUSTOMER][NEUTRAL] 2000
[AGENT][NEUTRAL] And 5.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, may I know the deductibles, individual deductibles, some deductables, and annual max.
[AGENT][NEUTRAL] Calendar year deductible is $50 per covered.
[AGENT][NEUTRAL] Up to 150 per family.
[AGENT][NEUTRAL] Calendar year maximum is $1000.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. May I know the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is the patient to the subscriber?
[AGENT][NEUTRAL] Yes they are.
[CUSTOMER][NEUTRAL] OK OK.
[CUSTOMER][NEUTRAL] I orthodontics is a covered benefit?
[AGENT][NEUTRAL] One moment.
[AGENT][NEGATIVE] There is no ortho coverage on the member plan.
[CUSTOMER][NEGATIVE] So no, there is no lifetime maximum for author, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is there any history that affect the frequencies?
[AGENT][NEUTRAL] Uh, let me check one moment.
[AGENT][NEUTRAL] Last date of service on file for the patient procedure code 11:10, uh was date of service [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And last bit wing was on [PII].
[AGENT][NEUTRAL] Patient plan permits once every 6 months.
[CUSTOMER][NEUTRAL] Or which or what code?
[CUSTOMER][NEUTRAL] 1769.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] It was for procedure code 0274.
[CUSTOMER][NEUTRAL] 0274. OK. What is the, what's the date?
[AGENT][NEUTRAL] That was for [PII].
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] Well, is there any stress?
[AGENT][NEUTRAL] Uh, no other history that should affect frequency.
[CUSTOMER][NEUTRAL] OK, for prophylaxis or 1110 and 0274. The streets are 93224 and 02743326224. Is that correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah, and there are no one else near the streets.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and may I know your name and call reference ID?
[AGENT][NEUTRAL] Call reference is my name with my last initial in today's date. My name is [PII], which is [PII] Last initial is [PII]. Today's date is [PII].
[CUSTOMER][NEUTRAL] I just, uh, I'm confused with call reference ID. Could you please repeat it again?
[AGENT][NEUTRAL] Call reference is my name, which is [PII]
[CUSTOMER][NEUTRAL] AH OK.
[AGENT][NEUTRAL] My last, my last initial [PII].
[CUSTOMER][NEUTRAL] So there is, there is no space, right?
[AGENT][POSITIVE] You can do it all together, yes.
[CUSTOMER][NEUTRAL] OK. [PII], [PII], [PII].
[AGENT][NEUTRAL] And then today's date, [PII].
[CUSTOMER][NEUTRAL] Today
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh thank you so much, sir. That's it for my day. Thank you for the information. Have a nice day.
[AGENT][NEUTRAL] You too, [PII] bye bye