AccountId: 011433970860
ContactId: 4b54dfe9-8186-4350-a737-1c9e3ad8ed91
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 349500 ms
Total Talk Time (AGENT): 184965 ms
Total Talk Time (CUSTOMER): 73845 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/4b54dfe9-8186-4350-a737-1c9e3ad8ed91_20250604T12:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes I'm going to check on dental benefits for a patient that's in the office.
[AGENT][NEUTRAL] OK, you're needing dental benefit information, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And on our dental policies, we do have facts backs of the member's benefit for the type of plan that they have that I'll be happy to send to you also.
[CUSTOMER][POSITIVE] OK, that'd be great.
[AGENT][NEUTRAL] So, so first off, who am I speaking with, please?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] Thank you and [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and what is the member's policy number, please?
[CUSTOMER][NEUTRAL] It is 021-65758.
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments [PII] to get the member's information pulled up please.
[CUSTOMER][POSITIVE] Alright, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Good good
[AGENT][NEUTRAL] OK, and any information [PII] that I do provide today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII], it is [PII].
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, so there's something off on the policy number or I heard it wrong. I heard you say 021657-557.
[CUSTOMER][NEUTRAL] 58.
[CUSTOMER][NEUTRAL] Last last numbers in [PII].
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Sorry
[AGENT][NEUTRAL] OK, and again, as I stated before, any information provided would be a verification of benefits and not a guarantee of payment. So what is his date of birth again?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that he is the subscriber on this dental plan and the policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you'll give me a moment to get his factsite pulled up, I'll be happy to send you his benefit information. We do not have any history on file for him.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Would you be able to tell me if we're in network with this plan?
[AGENT][NEUTRAL] This plan is not a network plan. The coverage services are based on a percentage of the UCR of the service region.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], I mean, [PII], I'm so sorry. [PII], will this need to be sent to you, jeez, I'm, maybe I need to wake up a little more this morning. Do, um, I need to have your name on the fax back or is that not necessary?
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] No, it's not necessary.
[AGENT][NEUTRAL] OK, one moment
[AGENT][NEUTRAL] And what is a good fax number for you please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and I'm definitely gonna repeat that since I can't hear very well this morning. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's correct, thank you.
[AGENT][NEUTRAL] OK, so I have just sent that to you, so you should be receiving that very soon, um, and also if you will file a claim with us on this policy, [PII], once the claim has been processed, we do have a portal that you should be able to check claim status in, and the portal website is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so we have to uh register for that, right?
[AGENT][NEUTRAL] You do. It's a self registering portal and again that is for claim status.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Alright, um, let's see, you said it's UCR fee, is that what you said?
[AGENT][NEUTRAL] Correct. Mhm. Covered services are based on a percentage of the UCR of the service region and that is also stated on that fax back as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK all right thank you very much.
[AGENT][POSITIVE] Well, you're very welcome. Can I help you with anything else?
[CUSTOMER][NEUTRAL] Is there any a deductible on the plan?
[AGENT][NEUTRAL] There is a $50 per cover person.
[AGENT][NEUTRAL] Or per covered insured up to 150 per family and the max is 1500 per calendar year and that information is also gonna be on the first page under his name and effective date and policy number.
[CUSTOMER][NEUTRAL] How about the max?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] Well, you are very welcome and again thank you for calling APL [PII]. I hope you have a great day.
[CUSTOMER][POSITIVE] Yep you too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.