AccountId: 011433970860
ContactId: 48d689e5-b2a9-4f00-b390-7ad093ad0372
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 301339 ms
Total Talk Time (AGENT): 142000 ms
Total Talk Time (CUSTOMER): 127892 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/48d689e5-b2a9-4f00-b390-7ad093ad0372_20250221T16:53_UTC.wav
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[AGENT][NEUTRAL] Hello.
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling on behalf of dental office to check on benefit for a patient today. Can you help me with that, please?
[AGENT][NEUTRAL] Sure, I can assist you with that. Could you provide me with the spelling of your name and a callback number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes. Uh, my name is spelled as [PII].
[AGENT][NEUTRAL] Thank you, [PII], and what is your callback number and that policy number of the member that you're inquiring benefits for today?
[CUSTOMER][NEUTRAL] Yeah, sure. The callback number that is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the policy number that is 02277446.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] those
[AGENT][NEUTRAL] [PII], could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, that's [PII]. Last name is [PII] with the date of birth [PII].
[AGENT][NEUTRAL] You're calling to verify benefits eligibility. This member's policy has been active since [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's currently active.
[CUSTOMER][NEUTRAL] Mhm. And what is the group name and number?
[AGENT][NEUTRAL] The group number is 22,040.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the group name is Universal Trucking Shelton. S as in Sally, H as in Howard, E as in Echo, L as in Lima, T as in Tom, O as in orange, N as in Nancy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] All right. And uh what's the claim's mailing address?
[AGENT][NEUTRAL] The mailing address will be addressed to American Public Life Claims Department.
[AGENT][NEUTRAL] [PII], that's [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]. That's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, perfect. Thank you. I got it. And what is the maximum deductibles on the policy?
[AGENT][NEUTRAL] The yearly max per calendar year is $1500 with a $50 deductible up to $150 per family that does not apply to us preventative services and this is not a guarantee of benefits it's just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, and nothing has been used on that for the calendar year.
[AGENT][NEUTRAL] The member has not utilized any of their benefits for 25 nor met their deductible and the member has not utilized the policy since it's been active since [PII], so there's no history on file, [PII].
[CUSTOMER][NEUTRAL] OK. All right, perfect. And there are no auto coverage on the plan?
[AGENT][NEUTRAL] No, there isn't.
[CUSTOMER][NEUTRAL] OK. And no waiting periods, no missing tooth cloths on the policy as well?
[AGENT][NEUTRAL] There is a waiting period, however, it exhausted [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And there is a missing tooth cloth.
[CUSTOMER][NEGATIVE] OK, that is a missing cloth.
[AGENT][POSITIVE] And I can send you a fax back if you would like. Yes, that's correct.
[CUSTOMER][NEUTRAL] Oh, OK, you can send me the fax back for the frequency I can.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, what's your fax number, [PII]?
[CUSTOMER][NEUTRAL] A fax number that is uh [PII].
[AGENT][NEUTRAL] I have [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] Yes, that's right.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Uh yes. Uh, just 12 questions like, uh, for the SRPs, can we do all the 4 quarters on the same day?
[AGENT][NEUTRAL] What is your procedure code?
[CUSTOMER][NEUTRAL] That is 4341.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] In and out of of benefits to take the same.
[AGENT][NEUTRAL] 4341
[AGENT][NEUTRAL] For your limitations of 43, 41, the limitations are as follows.
[AGENT][NEUTRAL] Maximum of 1 each quadrant per 24 months. That's the only limitation.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] All right. So there's no guidance for that. All right. And lastly, any downgrades on the plan?
[AGENT][POSITIVE] There's no downgrade.
[CUSTOMER][NEUTRAL] OK, no downgrades. All right. Perfect. OK, then I'm done with all the questions for the patient. Can you help me with the reference number as you sent the back for the benefits?
[AGENT][NEUTRAL] We don't provide reference numbers, [PII], however, you can feel free to use my name and today's date as a reference. My name is [PII], spelled [PII]. First initial, my last name is [PII], and today's date.
[CUSTOMER][POSITIVE] All right, got you. All right then, well, thank you, [PII]. Thank you for your help. Thank you for assisting me.
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APL. Have a great weekend. Goodbye.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] You too. Have a great day and happy weekend. Bye-bye. Stay safe. Thank you.
[AGENT][POSITIVE] Thanks. Goodbye.
[CUSTOMER][NEUTRAL] Bye.