AccountId: 011433970860
ContactId: 3e217967-ec67-45b0-be2e-cd4cf598fd8e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201529 ms
Total Talk Time (AGENT): 86318 ms
Total Talk Time (CUSTOMER): 78630 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/3e217967-ec67-45b0-be2e-cd4cf598fd8e_20250103T19:15_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], good afternoon. Uh, my name is [PII]. I'm calling to check on dental benefits and eligibility for a patient.
[AGENT][NEUTRAL] OK, yeah, I can check benefits and eligibility for you. I'm sorry, did you say your name was [PII]?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] OK, and can I get a good call back number from you really quick in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh, sure, it is [PII].
[CUSTOMER][NEUTRAL] 220
[CUSTOMER][NEUTRAL] 4790.
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Um, yes, it is 02363607.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK. And uh what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Um, first name is, um, [PII], um, last name is [PII], and birth [PII].
[AGENT][NEUTRAL] OK, perfect, thank you for verifying that, [PII]. So this policy is active, effective date was [PII] and if you'd like, I can send you the fax back uh showing covered procedures and benefit information.
[CUSTOMER][POSITIVE] That would be great.
[AGENT][NEUTRAL] OK, one moment please.
[AGENT][NEUTRAL] OK, uh, uh, what was that fax number for you?
[CUSTOMER][NEUTRAL] Um, it would be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm gonna read that back, make sure I heard that correctly. That was 832.
[AGENT][NEUTRAL] 2204802
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I'm gonna just put this to your attention.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] C
[AGENT][NEUTRAL] Would I just put it to your attention, [PII]?
[CUSTOMER][NEUTRAL] Uh, yes, that's fine.
[AGENT][NEUTRAL] OK, alright, I will get that sent to you. You should get it here maybe 10-15 minutes depending on how busy your machine is. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Um, yes, are you able to see if, um, we are in network with this plan? I'm not entirely sure.
[AGENT][NEUTRAL] Sure, so this plan does not have a set network. It goes strictly off of UCR.
[AGENT][NEUTRAL] And you would just file those claims directly to us.
[CUSTOMER][NEUTRAL] Oh, I see.
[CUSTOMER][NEUTRAL] Got you so shouldn't all claims um via mail?
[AGENT][NEUTRAL] Um, I have a mailing address, fax number, and a payer ID. They will all be on the fax back, but I can give them to you now if you'd like.
[CUSTOMER][NEUTRAL] Uh, no, the first pack is fine. So, um, when it comes to coverage, does it go based on percentage, maybe kind of like a PBO policy?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, it's so it's percentage of UCR though, so preventative, for example, is 100%, basic is 80, major is 40.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] Perfect. OK, so we'll just wait for the fax and then if we need any uh additional information we'll call back.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Absolutely sounds good. Well thanks for giving us a call [PII]. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you you as well.
[AGENT][POSITIVE] Thank you bye bye.