AccountId: 011433970860
ContactId: 4195d2d0-4024-4578-b69c-c0cb2f4f359b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 451470 ms
Total Talk Time (AGENT): 147806 ms
Total Talk Time (CUSTOMER): 153666 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/4195d2d0-4024-4578-b69c-c0cb2f4f359b_20250117T16:12_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] My name is [PII]. I'm searching for dental benefits.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Hello, my name is [PII].
[AGENT][POSITIVE] Hi [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] I'm searching for dental benefits.
[AGENT][NEUTRAL] You said you're needing some benefit information, is that correct?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I need dental benefit, ma'am.
[AGENT][NEUTRAL] Dental benefits, you bet you. I'm sorry, it's kind of hard to hear you, um, and what is a good callback number I can have?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Perfect, thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is 000603552.
[AGENT][NEUTRAL] All right, let me look at that up for you.
[CUSTOMER][NEUTRAL] Yeah OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] There is
[CUSTOMER][NEUTRAL] 9.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] And would you be able to verify for me please your insured's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the, it's uh [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Perfect, I do see her here. Give me a second to look at her benefit information.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And are you wanting me to send you a fax back of benefits?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, I'm only checking for, uh, history, ma'am.
[AGENT][NEUTRAL] Oh, on history? OK, understood.
[AGENT][POSITIVE] Um, perfect.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I will get your history instead then for you one second.
[CUSTOMER][NEUTRAL] 5.
[AGENT][NEUTRAL] All right. And what history information can I help you with for her today?
[CUSTOMER][NEUTRAL] Yeah, is there any history for exam?
[AGENT][NEUTRAL] Um, let's see. Her last exam was [PII].
[CUSTOMER][NEUTRAL] Can you give me the full date of service?
[AGENT][NEUTRAL] Yep, [PII].
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] OK. And is there any history for FMX and Pao?
[AGENT][NEUTRAL] Uh, yes, there is one sec.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] All right, um.
[AGENT][NEUTRAL] Her last.
[AGENT][NEUTRAL] Panel was the same date, [PII] and
[CUSTOMER][NEUTRAL] What's the date of service [PII], right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and is there a history for buy drinks?
[AGENT][NEUTRAL] Yes, same date, um.
[CUSTOMER][NEUTRAL] OK, and is there any history for profit?
[AGENT][NEUTRAL] Sorry, let me go back to the top. Hang tight.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Same day, yes.
[CUSTOMER][NEUTRAL] OK. Now, is there any history for SRP?
[AGENT][NEUTRAL] I don't know what SRP means. I'm sorry.
[CUSTOMER][NEUTRAL] It's, the code is 4341 and 4342.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] I, I want you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I walk.
[AGENT][NEUTRAL] Thanks for your patience. So for 4341, I don't show any history, and then what was that last, the second one you wanted me to check?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] 43421.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I'm not showing any history for that procedure either.
[CUSTOMER][NEUTRAL] OK, and what's the group number?
[AGENT][NEUTRAL] Group number is LA 01.
[AGENT][NEUTRAL] 45.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. And the group name?
[AGENT][NEUTRAL] Health and hospitals.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. And what's the effective date?
[AGENT][NEUTRAL] Effective date is [PII].
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK, and what about annual maximum and remaining?
[AGENT][NEUTRAL] OK, perfect. I do wanna let you know that any of that information I give over the phone is just the verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] The annual.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Maximum is $1000 a year. The deductible is $50 a year and
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] The exams and profies do not apply to the deductible.
[CUSTOMER][NEUTRAL] OK, and anything used in annual maximum and uh deductible?
[AGENT][NEUTRAL] We haven't um used anything for the [PII] calendar year so far.
[CUSTOMER][NEUTRAL] OK. And what about or last maximum?
[AGENT][NEUTRAL] What about what maximum?
[CUSTOMER][NEUTRAL] I'll call that the maximum, ma'am.
[AGENT][NEUTRAL] I don't have a different maximum listed. I don't know. I'm sorry.
[CUSTOMER][NEUTRAL] And it auto maximum, uh, is, is it, uh, $1000?
[AGENT][NEUTRAL] The calendar year maximum is $1000 yes.
[CUSTOMER][NEUTRAL] OK. May I have your name?
[AGENT][NEUTRAL] Yeah, my name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Last initial, initial [PII].
[CUSTOMER][NEUTRAL] OK, and the callback reference number?
[AGENT][NEUTRAL] It's gonna be my name in today's date.
[CUSTOMER][NEUTRAL] OK, ma'am.
[CUSTOMER][POSITIVE] Yeah, I'm done with the patient. Thank you, ma'am. Have a good day. Bye-bye.
[AGENT][POSITIVE] My pleasure. Bye-bye.