AccountId: 011433970860
ContactId: 3fea7966-7d00-466d-81ab-6316ea63a203
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 333010 ms
Total Talk Time (AGENT): 101219 ms
Total Talk Time (CUSTOMER): 82556 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/3fea7966-7d00-466d-81ab-6316ea63a203_20250220T20:59_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from provider's office. I was calling to get benefits and eligibility for a patient.
[AGENT][NEUTRAL] OK. Did you say your name was [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, and do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Uh, yes, exactly, um, of course, phone number is gonna be area code [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have their policy number?
[CUSTOMER][NEUTRAL] Uh, policy number that I have, let me get that for you. It is gonna be 011.
[CUSTOMER][NEUTRAL] 21133.
[AGENT][NEUTRAL] 133
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, hold on one moment, please.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] And the patient's name?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII] last name [PII]
[AGENT][NEUTRAL] And the date of birth.
[CUSTOMER][NEUTRAL] Uh, her date of birth is gonna be [PII].
[AGENT][POSITIVE] Thank you, [PII], and you're needing benefits?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, I can help you with that. Do you want them over the phone or would you like a fax back?
[CUSTOMER][NEUTRAL] Um, can I get both?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] The effective date is [PII].
[AGENT][NEUTRAL] Any benefits given over the phone is not a guarantee of payment?
[AGENT][NEUTRAL] The calendar year maximum is 1500.
[AGENT][NEUTRAL] Deductible is $50. It applies to all classes, but preventative.
[AGENT][NEUTRAL] Preventative is paid at 100% of usual and customary rate.
[AGENT][NEUTRAL] Basic is 80%.
[AGENT][NEUTRAL] Major is 40%.
[AGENT][NEUTRAL] Endopperio or surgery crowns, bridges, parcels, dentures is all under major.
[AGENT][NEUTRAL] And what else were you needing?
[CUSTOMER][NEUTRAL] Um, is there any listing to close or waiting periods that applies?
[AGENT][NEGATIVE] There is a missing tooth cloth. They've already met the waiting period.
[CUSTOMER][NEUTRAL] And then, um, are the assignments the benefits accepted?
[AGENT][NEGATIVE] I didn't understand the question.
[CUSTOMER][NEUTRAL] Um, assignment of benefits.
[AGENT][POSITIVE] Yes, we do accept assignment.
[CUSTOMER][NEUTRAL] OK, and then, uh, let's see, uh, for the Kia, does she have any preventative history on file?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] The last time she had a cleaning was 44 of 24.
[AGENT][NEUTRAL] Clean and bite wing exam.
[AGENT][NEUTRAL] She had a full mouth X-ray 3 1323.
[AGENT][NEUTRAL] And that's all I'm seeing for preventative.
[CUSTOMER][NEUTRAL] OK and then um what is the um.
[CUSTOMER][NEUTRAL] Group name and group number?
[AGENT][NEUTRAL] It is
[AGENT][NEUTRAL] The group number is 15395.
[AGENT][NEUTRAL] The group name is Universal Trucking.
[CUSTOMER][NEUTRAL] OK, and then I could go back I think could get the rest of them the I have information from there.
[AGENT][NEUTRAL] What is your fax number?
[CUSTOMER][NEUTRAL] It's gonna be area code 682.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'll fax that to you.
[CUSTOMER][NEUTRAL] OK, and if I can get a reference number.
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you, [PII] for calling APO. You have a good afternoon.
[CUSTOMER][POSITIVE] OK [PII] thank you bye bye.
[AGENT][NEUTRAL] Bye bye.