AccountId: 011433970860
ContactId: 3ececc7f-e7f9-4302-86a1-6348c69b43fd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251039 ms
Total Talk Time (AGENT): 129716 ms
Total Talk Time (CUSTOMER): 61191 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/3ececc7f-e7f9-4302-86a1-6348c69b43fd_20250206T19:47_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, I would like to check on benefits and coverage for patients.
[AGENT][NEUTRAL] OK, you're needing benefits and eligibility, is that correct?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Yes, ma'am, I can help you, and who am I speaking with?
[CUSTOMER][NEUTRAL] Uh, this is [PII] with Discover Dentistry.
[AGENT][NEUTRAL] OK, [PII], so you're needing a fax back of the member's benefits, is that correct?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm, could you give me any coverage over the phone?
[AGENT][NEUTRAL] As far as dental policies?
[AGENT][NEUTRAL] I can, but for our dental policies we have facts facts that have that have all the members' information on there for the type of plan that they have.
[CUSTOMER][NEUTRAL] OK, OK, that's fine.
[AGENT][NEUTRAL] First off, [PII], what is a good callback number for you in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] Let me get that option
[CUSTOMER][NEUTRAL] It's 02097917.
[AGENT][NEUTRAL] OK, thank you. So give me a couple of moments to get the member's information pulled up, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and any information that I do provide for you today, [PII], will be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It is for [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. So I do show that he is the subscriber on this policy and this policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Um, does he have a yearly max?
[AGENT][NEUTRAL] The calendar year maximum benefit is $500 per covered insured with a $50 calendar year deductible for covered insured.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] And that information would be included on the fax back if you want that sent.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um, are you ready for the number?
[AGENT][NEUTRAL] Oh, OK. So give me just one second to get that pulled up.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] No problem
[AGENT][NEUTRAL] Does it need to be put to your attention or is that not necessary?
[CUSTOMER][NEUTRAL] Um, it doesn't matter.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm yeah you could just any um.
[AGENT][NEUTRAL] And what is a good fax number to send this to, [PII]?
[CUSTOMER][NEUTRAL] It'll be [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm just gonna repeat that back to you. [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct, yes ma'am.
[AGENT][NEUTRAL] All right. So I have just sent that to you. So you should be receiving that within just the next few minutes. And also, [PII], anything that is not on the fax side means it is not covered by his policy.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then lastly once we have received and processed the claim, we do have a portal that you should be able to check claim status in and have access to the EOB and our portal website is [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] You said [PII]?
[AGENT][POSITIVE] Yes, ma'am, [PII]. That's correct.
[CUSTOMER][POSITIVE] Awesome.
[AGENT][NEUTRAL] And is there anything else, [PII], that I can help you with?
[CUSTOMER][POSITIVE] Um, no, that should be good for now, and then I'll just wait on the fax back. Thank you very much.
[AGENT][POSITIVE] OK. Well, you are certainly very welcome. So thank you again for calling APL and I hope you have a great afternoon.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.