AccountId: 011433970860
ContactId: 3be93dc1-8472-417b-8cdd-11bc9ed6e85f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 292640 ms
Total Talk Time (AGENT): 87538 ms
Total Talk Time (CUSTOMER): 119091 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/3be93dc1-8472-417b-8cdd-11bc9ed6e85f_20250219T17:06_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hello [PII], good morning. This is [PII] speaking, and I'm calling to check the eligibility and benefits for a patient, please.
[AGENT][POSITIVE] I'd be happy to assist with benefits and eligibility today [PII] if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Yeah, sure. It's gonna be [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Policy number, a member ID number or social security number?
[AGENT][NEUTRAL] Um, member ID number.
[CUSTOMER][NEUTRAL] I have the social. It's gonna be [PII].
[AGENT][NEUTRAL] Oh, OK. Hold on.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You said [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth [PII].
[AGENT][NEUTRAL] And this is for dental correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII]. And were you needing a back back breakdown of the benefits?
[CUSTOMER][NEUTRAL] Oh, no. I just wanna know if this patient has any accumulation and if the COVD72102 number 16 is covered under this policy.
[AGENT][NEUTRAL] You said what was the code again? I'm sorry.
[CUSTOMER][NEUTRAL] 7 to 10.
[AGENT][NEUTRAL] 7210.
[AGENT][NEUTRAL] I don't see a code 7210 on here. Is that a major service? Because major is not covered under the policy.
[CUSTOMER][NEUTRAL] Let me check.
[CUSTOMER][NEUTRAL] Oh, I don't know if it made part of the Mayor services. I think that it's gonna be 4 basis.
[AGENT][NEUTRAL] And you said 7210?
[CUSTOMER][NEUTRAL] 72 to 10. Yeah, I'm sorry. Yes, 7 to 10, 7 to 10.
[CUSTOMER][NEUTRAL] It's for a session.
[AGENT][NEUTRAL] No, 7210 is not on here.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEGATIVE] It's, it means that it's not covered. 7714, 7 to 10, 7 to 20, 7 to 30 are not covered.
[AGENT][NEUTRAL] 7
[AGENT][NEUTRAL] And what type of services are these?
[CUSTOMER][NEUTRAL] So regarding to the information that I got here, it, it seems that those costs are covered under basic 80%.
[CUSTOMER][NEUTRAL] But I'm not sure if that information is right.
[AGENT][NEUTRAL] Now 7140 is on here.
[CUSTOMER][NEUTRAL] That one is covered under basic, right? 7140, but the other one's from 7 to 10.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I don't see the other ones.
[CUSTOMER][NEUTRAL] Oh, it means that the other ones are not covered.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And regarding to the annual market, I see that.
[CUSTOMER][NEUTRAL] Is 500. Can you please let me know what is the accumulation?
[AGENT][NEUTRAL] Um, so.
[AGENT][NEUTRAL] So of that, she has used $222.60.
[CUSTOMER][NEUTRAL] You say $222.50.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] 22,260, OK.
[CUSTOMER][NEUTRAL] That's the, that the patient already use.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Patient already used 222 and 67.
[AGENT][NEUTRAL] Yes, that's what they've used out of the $500.
[CUSTOMER][NEUTRAL] Uh uh.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] OK. Can you spell your name for me, please? You say [PII]?
[AGENT][NEUTRAL] Yes, it's [PII]. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Yes, what is the reference number for the call?
[AGENT][NEUTRAL] Reference is just my name [PII] last [PII] [PII], and the date and time of the call.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I think that's all by now. Thank you so much for providing me that information. Have a good day and take care. Bye-bye.
[AGENT][POSITIVE] Thank you for calling ATO have a good day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye.
[AGENT][NEUTRAL] Mhm