AccountId: 011433970860
ContactId: 467714ca-715a-4968-a141-16aa07628fcd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 292350 ms
Total Talk Time (AGENT): 95991 ms
Total Talk Time (CUSTOMER): 81977 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/467714ca-715a-4968-a141-16aa07628fcd_20250310T15:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I just have a few specific questions about a patient's eligibility and benefits.
[AGENT][NEUTRAL] OK, I can help you with both eligibility and benefits. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and the callback number is um.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Callback number is [PII].
[AGENT][NEUTRAL] OK, thank you, Ms. [PII], and what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Doctor [PII] Gardner Wade's Cosmetic and Family Dentistry.
[AGENT][NEUTRAL] OK, and may I get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes. Their name is [PII]. The date of birth is [PII], and her
[CUSTOMER][NEUTRAL] I'm sorry, did you need the patient or the policy holder?
[AGENT][NEUTRAL] The patient.
[CUSTOMER][NEUTRAL] OK, yes, [PII], date of birth is [PII] and the member ID is 616994.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy. Her effective date is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And if you can give me your fax number, I can send you a fax back with her benefit breakdown and fee schedule.
[CUSTOMER][NEUTRAL] I just have a few specific questions.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, has she met her deductible and what's remaining from her maximum?
[AGENT][NEUTRAL] OK, let me check that real quick for you.
[AGENT][NEUTRAL] OK, she still has her maximum $1000 and this is just to verify her benefits. It's not to guarantee payment. She still has her $1000 maximum left and she still has her $50.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Co-pay to pay.
[CUSTOMER][NEUTRAL] OK, and is she eligible for her exam cleanings by Wingspano FMX?
[AGENT][NEUTRAL] For deductible.
[AGENT][NEUTRAL] Uh, let me look and see.
[AGENT][NEUTRAL] Yes, she hasn't had anything done since.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So she wouldn't be eligible for the PAO or FMX.
[AGENT][NEUTRAL] Let me pull up her fee schedule real quick and see how often she can get that done.
[AGENT][NEUTRAL] It's gonna be just a sec while the computer pulls it in for me.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] You're looking for can access the portal.
[CUSTOMER][NEUTRAL] Did you try the national.
[AGENT][NEUTRAL] She is eligible. She can have them once every 6 months.
[CUSTOMER][NEUTRAL] Uh pano.
[CUSTOMER][NEUTRAL] [PII]?
[CUSTOMER][POSITIVE] Uh, I'm interested in.
[AGENT][NEUTRAL] Let me look at her panel, but her cleanings are once every 6 months. Let me see about her pan.
[CUSTOMER][NEUTRAL] Yes, I was asking about uh [PII] and [PII].
[AGENT][NEGATIVE] She's not eligible for that because that's once every 3 years.
[CUSTOMER][NEUTRAL] OK