AccountId: 011433970860
ContactId: 43fb7475-fbe3-4f5a-9c8d-8f0ea123ce3d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229559 ms
Total Talk Time (AGENT): 87560 ms
Total Talk Time (CUSTOMER): 48371 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/43fb7475-fbe3-4f5a-9c8d-8f0ea123ce3d_20250508T14:50_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, yes, I was calling to see if the patient was still active.
[AGENT][POSITIVE] OK, I can definitely help you with the eligibility. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] 613-324
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing that the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] OK, and how much of per max does she use this year?
[AGENT][NEUTRAL] Let's see, hold on one moment.
[AGENT][NEUTRAL] For [PII], she's used $40 of the $1000 max, so she has $960 left. And has she met any of the deductible? Hold on one second.
[AGENT][NEUTRAL] And she has $30 left for the deductible to meet.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, so she met $20 of her deductible?
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Yes, because it's 50 for the year.
[CUSTOMER][NEUTRAL] Does the deductible apply to all services?
[AGENT][NEUTRAL] Not preventative.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] What else did she have done this year? We just have that she had preventative services done.
[AGENT][NEUTRAL] OK, um, hold on one moment.
[AGENT][NEUTRAL] So you're wanting to know what she used her benefits for for [PII]?
[CUSTOMER][NEUTRAL] Yeah, for her deductible.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] As in like what was the deductible applied to?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] It was applied to her bite wings.
[AGENT][NEUTRAL] Oh, that's it. 00274.
[CUSTOMER][NEUTRAL] So buy wings
[CUSTOMER][NEUTRAL] By wings are not considered preventative.
[AGENT][NEUTRAL] Let me pull up her fax back. Hold on one moment.
[AGENT][NEUTRAL] OK, so my apologies. The deductible for this policy does not apply to exams or profe. Bite wings are preventative. The $20 was applied to the bite wings.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What about all the other X-rays? Does the $50 apply?
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Like the FMX and PA.
[AGENT][NEUTRAL] Yes, it will apply to everything except exams and cleanings.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well that's all I needed.
[AGENT][POSITIVE] All right, [PII]. Well, thank you so much for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.