AccountId: 011433970860
ContactId: 4c955bc8-76db-4032-889c-a473b9775ebd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172619 ms
Total Talk Time (AGENT): 90520 ms
Total Talk Time (CUSTOMER): 70101 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/4c955bc8-76db-4032-889c-a473b9775ebd_20250129T21:44_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was just calling to get some information, some eligibility information on the, um, a patient.
[AGENT][NEUTRAL] OK, so you only need eligibility. You do not need benefit information, is that correct?
[CUSTOMER][NEUTRAL] Right, yes, ma'am, just wanna know if it's PPO and then also if we're in network.
[AGENT][POSITIVE] Yes, ma'am. I can help you with those things. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And Joo, what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, [PII]?
[CUSTOMER][NEUTRAL] Yes, it's 02554436.
[AGENT][NEUTRAL] Thank you one moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this is for dental that you're calling about?
[CUSTOMER][NEUTRAL] Yes, yes, ma'am.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, the policyholder is [PII]. His birthday is [PII].
[AGENT][NEUTRAL] And he is your patient. Is that correct?
[CUSTOMER][NEUTRAL] No, I believe it's either the daughter or the wife that called.
[AGENT][NEUTRAL] Who is the, what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm. And her date, OK. Her date of birth?
[CUSTOMER][NEUTRAL] And yeah, I didn't get that information. She just wanted to know we were in network and um well I wanted to know if we were in network because we've never heard of the dental plan before.
[AGENT][NEUTRAL] OK, so I can verify that [PII] is the subscriber for this dental policy, and this is not a network plan. So they may choose any provider to go to. This covered, the covered benefits on this policy are based on a percentage of the UCR of the service region. Again, it is not a network plan.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and what is the fee schedule?
[AGENT][NEUTRAL] There is not a fee schedule. Again, this is based on the percentages of the UCR.
[CUSTOMER][NEUTRAL] Based on percentage of UCR.
[AGENT][NEUTRAL] Mhm. Mhm. Of the service region, that is correct.
[CUSTOMER][NEUTRAL] OK, and is this PCO or HMO?
[AGENT][NEUTRAL] Neither.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty well thank you so much.
[AGENT][POSITIVE] Absolutely. You're very welcome. So is there anything else, um, Grill that I can help you with today?
[CUSTOMER][NEUTRAL] No, ma'am, that's all.
[AGENT][POSITIVE] All right. Well then, thank you very much for calling APL and I hope that you have a very nice evening.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye-bye.