AccountId: 011433970860
ContactId: 37828e80-4389-450a-8c6c-78056fbc23e6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 368170 ms
Total Talk Time (AGENT): 109637 ms
Total Talk Time (CUSTOMER): 161130 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/37828e80-4389-450a-8c6c-78056fbc23e6_20250107T19:54_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] Oh hello, [PII]. Good day. By the way, my name is [PII] and my name is spelled [PII]. And I'm calling from the office of Doctor [PII]. How are you doing today?
[AGENT][POSITIVE] I'm doing good. How are you?
[CUSTOMER][POSITIVE] I'm fine as well thank you for asking, [PII].
[AGENT][POSITIVE] You're welcome, and how may I assist you today?
[CUSTOMER][NEUTRAL] OK. Yes, by the way, [PII], I may need help in regards to my patients breakdown here. Um, you know, I need to confirm some of the things and, you know, it's [PII]. So I wanted to make sure if there, you know, things that on the breakdown. So yes, I'm calling again.
[AGENT][NEUTRAL] OK, so you want to go over the, is this for dental?
[CUSTOMER][NEUTRAL] Yes, dental.
[AGENT][NEUTRAL] So you're wanting to go over their, their benefit breakdown for this [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and may I have a good contact number in case we're disconnected and the member's policy number?
[CUSTOMER][NEUTRAL] OK. Uh, callback number [PII], no extension. And what do you need again, the group number or the ID number?
[AGENT][NEUTRAL] The policy number. Mhm.
[CUSTOMER][NEUTRAL] Oh, the ID number.
[CUSTOMER][NEUTRAL] Yeah, 0246.
[CUSTOMER][NEUTRAL] 446 7.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And hold on one moment while I pull the dental benefits for you.
[AGENT][NEUTRAL] OK, um, so the policy has been active since [PII] and the benefits are still the same for the [PII], but what questions did you have?
[CUSTOMER][NEUTRAL] Uh, so, uh, I just wanted to ask about the yearly max. Is it still the same? $500?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, perfect. And the remaining is $500 still. Nothing has been met? Nothing has been used?
[AGENT][NEUTRAL] Um, let me see if they've used any for this year. Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah. Yeah, that is that the thing that we really need to sack.
[AGENT][NEUTRAL] Um, so no, she has not used any of the benefits for [PII] yet.
[CUSTOMER][NEUTRAL] OK. How about for the deductible? Is it 50 for, is it still $50 for individual and 150 for family?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] And nothing has been met yet, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. For the Ortho Max or the benefits, is it still, um, I mean, is it still not covered or is it covered for this year?
[AGENT][NEUTRAL] No, the benefits are the same. There is no orthodontic coverage.
[CUSTOMER][NEUTRAL] OK. Um, for the deductible, it only applies to basic. Is that correct?
[AGENT][NEUTRAL] It applies to, well, yes, because the policy only covers preventative and basic, so yes.
[CUSTOMER][NEUTRAL] Mhm. And major is not covered still, right? In the period oral surgery?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] So, in the period oral surgery, like the major services, it's not covered.
[AGENT][NEGATIVE] are not covered, correct.
[CUSTOMER][NEUTRAL] OK. All right. Um,
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] For the fluoride instant, is it still 100%, 1 for 12 months for fluoride and one for 3 to 6 months for it still?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, great. So I think um everything is actually like the same. Um, simple extraction is covered, right? 80% 7140, 1 per lifetime.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, got it. And by the way, I may need like a reference number for this call.
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII], and then today's date.
[CUSTOMER][NEUTRAL] Sorry, what is their name again?
[AGENT][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] My first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] In today's date, right? And by the way, is there any way that you can send me a fax back?
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, and what's a good fax number for you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yes, fax number is gonna be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you for that and that was [PII]?
[CUSTOMER][NEUTRAL] Right, that's the.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Alright, so I'll go ahead and fax the fax back over to you now. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] OK, I'll just wait for the back so that I can update it. I mean, I can update the.
[AGENT][NEUTRAL] Uh, you sound really far away now. Can you say that one more time?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I've done so far.
[AGENT][NEGATIVE] I'm sorry, the phone is breaking up.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] Uh, what I said is none so far. I'm all good.
[AGENT][POSITIVE] All right. Well, thank you so much for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] You as well. Goodbye.
[AGENT][POSITIVE] Thank you. Bye-bye.