AccountId: 011433970860
ContactId: 42b48e70-1a8c-4ead-989b-3a69ff23b4d3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 409000 ms
Total Talk Time (AGENT): 168413 ms
Total Talk Time (CUSTOMER): 136298 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/42b48e70-1a8c-4ead-989b-3a69ff23b4d3_20250402T12:04_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I was trying to verify dental benefits for a patient, but I was also trying to uh register on the online portal and it says the ID that I have or something for the patient is not correct, but I, I have an old fax back that has their number on it and I don't so I don't know why it's not let me register either but so.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so you're needing to get, OK, so you need to verify eligibility and benefits on a member, get another fax back for a member? Do you need another fax back? OK, and then you're not able to set up a profile in the portal for some reason.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] Well, yeah.
[CUSTOMER][NEUTRAL] Yes, so I don't know.
[AGENT][NEUTRAL] OK, you know, I can try and help you with that. And so first off, who am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Thank you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you and what is the policy number for the member [PII]?
[CUSTOMER][NEUTRAL] Uh, what I have is 613-872.
[AGENT][NEUTRAL] OK, thank you, so give me a couple moments please to get the member's information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] You doing OK this morning?
[CUSTOMER][POSITIVE] Yeah doing good.
[AGENT][POSITIVE] That's good.
[CUSTOMER][NEUTRAL] How about yourself? It's early morning, isn't it?
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] It sure is.
[AGENT][NEUTRAL] Yes no it is.
[AGENT][NEUTRAL] Thank you any information that I provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Her name I think it's a her hold on [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Well,
[AGENT][NEGATIVE] Having trouble here with one of my.
[AGENT][NEUTRAL] There we go.
[CUSTOMER][POSITIVE] Oh goodness.
[AGENT][NEUTRAL] OK, so I do show that she is the subscriber on this general policy and it is active [PII]. The effective date on it is [PII].
[AGENT][NEUTRAL] And give me a moment to get her fax back information pulled up so I can go ahead and send that to you as well.
[CUSTOMER][NEUTRAL] OK, and while you're pulling that up, I, I had the old fax back from last year and on it I did not see a code for a retreat of root canals. So is that even a cover?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEGATIVE] OK, if it is not on the fax back, it would not be covered.
[CUSTOMER][NEUTRAL] OK, so I'll make note of that.
[AGENT][NEUTRAL] Yes, ma'am, uh huh.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Not, OK.
[CUSTOMER][NEGATIVE] And also I noticed on the fax back it doesn't give like an accumulation as far as if they've used any of their maximum or deductible. Could you help me with that?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, for this calendar year you're needing information to see if she's used anything for this calendar year? Yes, OK.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Alright, so for [PII] as of now, she has used uh $47 of her $50 calendar year deductible.
[AGENT][NEUTRAL] And a total of $121 of the benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK. And if you want to, you can go ahead. Can you receive faxes, I mean, while you're on the, on the call? Or do you need for me to wait? OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Yeah, absolutely, no, no.
[AGENT][NEUTRAL] All right. Give me
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, and what is your fax number please, [PII]?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, so I'm just gonna repeat that back. [PII].
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] OK, so I have just sent that to you now on and you all have filed claims with us in the past for Ms. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, for this lady, yes ma'am.
[AGENT][NEUTRAL] OK, so now when it's asking for the patient account number, that is the account number that you all have.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For her that you submit on the claim is it box 20.
[CUSTOMER][NEUTRAL] That oh that we have for her.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Correct. This is not her. I believe, uh, it did say, I know they're making some changes, a few changes in the online delivery center, but I believe
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Are you still there?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?