AccountId: 011433970860
ContactId: 560f9343-76f4-49f0-ae3d-b6d42a12960e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 629200 ms
Total Talk Time (AGENT): 153031 ms
Total Talk Time (CUSTOMER): 152395 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/560f9343-76f4-49f0-ae3d-b6d42a12960e_20250422T20:48_UTC.wav
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[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you for calling APO. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I'm sorry, what was the name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hey [PII], I'm trying to get um some dental benefit information.
[AGENT][NEUTRAL] OK, I can help you with benefits today. Do you have the policy number?
[CUSTOMER][NEUTRAL] Wait, we don't get all that.
[CUSTOMER][NEUTRAL] What is this?
[CUSTOMER][NEUTRAL] I'm sorry, it's 615-774.
[AGENT][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I mean we're just too busy to give quotes, you know, without scheduling appointments um but I can tell you what it is without.
[CUSTOMER][NEUTRAL] No, that's not a mo. this one's not a molar.
[CUSTOMER][NEUTRAL] I'm sorry, I'm trying to do two things at once.
[AGENT][NEUTRAL] Oh, you're totally fine. Um, what's the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Then there's 2 tooth numbers, two different teeth, OK.
[CUSTOMER][NEUTRAL] And date of birth [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, yeah.
[CUSTOMER][NEGATIVE] Yeah, and that's without insurance.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The day
[CUSTOMER][NEUTRAL] We're so busy.
[AGENT][NEUTRAL] Sorry, I'm gonna pull up their their facts back really quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And then what benefits were you wondering about today?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Uh, is there a group name or a group number?
[AGENT][NEUTRAL] See, there is.
[CUSTOMER][NEGATIVE] Yeah, I don't have time to do.
[CUSTOMER][NEUTRAL] Mm mm mm.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, there is not a group name or group number.
[CUSTOMER][NEUTRAL] OK, and is there a calendar year or been a year?
[AGENT][NEUTRAL] Um,
[AGENT][POSITIVE] There is a benefit year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And when does that start?
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] Never mind, there is not. There's not a waiting period on here.
[CUSTOMER][NEUTRAL] Oh, I didn't ask about the waiting period.
[AGENT][NEUTRAL] Um, I don't.
[CUSTOMER][NEUTRAL] I was asking about if it was calendar year benefit year and you said benefit year and I was trying to see when that started, what month did start over.
[AGENT][POSITIVE] 00, OK, I see. I'm so sorry.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Girl, I, I don't know who's, who, who's been more confused today myself too.
[AGENT][NEUTRAL] Oh jeez. Um, OK. So it looks like.
[AGENT][NEUTRAL] It starts over every July.
[CUSTOMER][NEUTRAL] July, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alright and then um what's her max and deductible and if she's used any?
[AGENT][NEUTRAL] OK, so this is not a guarantee of payment, it's just a verification of coverage. So the calendar year max is 1000 per covered insured.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the calendar year deductible is $50 per covered insured, up to $150 per family, and the deductible does not apply to exams or prophylaxis.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] And then she's used nothing you said?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Uh, let me look that up, see.
[AGENT][NEUTRAL] OK, and it looks like she has $975 left out of that $1000.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And has she used any of her deductible?
[AGENT][NEUTRAL] She has used 50.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And her percentages, what are they for the preventive basic and major?
[AGENT][NEUTRAL] See.
[CUSTOMER][NEUTRAL] You're
[AGENT][NEUTRAL] OK, so this policy gives me
[AGENT][NEUTRAL] The benefit amount.
[AGENT][NEUTRAL] It doesn't say percentages.
[AGENT][NEUTRAL] Can I send you over the fax back?
[CUSTOMER][NEUTRAL] So are they is it a
[CUSTOMER][NEUTRAL] Is it a fee schedule?
[CUSTOMER][NEUTRAL] Versus percentages.
[AGENT][NEUTRAL] Let me reach out to a colleague. I'm still pretty new. Just a moment, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Hey, thank you for holding.
[CUSTOMER][NEUTRAL] Uh huh
[AGENT][NEUTRAL] OK, do you mind if I give you a call back and send you this fax back over?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, um, I, I mean that's fine. I'm just, I'm just trying to get this insurance done for the day because this is my last one.
[CUSTOMER][NEUTRAL] They didn't they couldn't tell you if it's percentages or if it's a fee schedule?
[AGENT][NEUTRAL] No, so it.
[CUSTOMER][NEUTRAL] Because then I have all kinds of other questions if it.
[CUSTOMER][NEUTRAL] If it is.
[AGENT][NEUTRAL] Right, so at the top of here it says um like preventative is once every 6 months.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah that's just frequency.
[AGENT][NEUTRAL] Yeah. And then I'm not used to looking at these, this benefit um her dental.
[AGENT][NEUTRAL] Um, it has like benefit amounts for the for the codes.
[CUSTOMER][NEUTRAL] OK, so then it is a fee schedule.
[AGENT][NEUTRAL] It's a, OK.
[CUSTOMER][NEUTRAL] OK, yeah, yeah, then fax that to me.
[AGENT][POSITIVE] OK, I'm so sorry.
[CUSTOMER][NEUTRAL] That's OK. I just wanted to make sure I didn't have to stay on hold again and call back, you know.
[AGENT][NEUTRAL] Oh no, yeah, I get it.
[CUSTOMER][NEUTRAL] With it being so close to in the day.
[AGENT][NEUTRAL] Yes, OK, I'll send that right over to you. What's your fax number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, perfect. I'll send that over right away, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] OK. Thank you. Have a good day.
[CUSTOMER][NEUTRAL] All right bye bye. You too, bye bye.
[AGENT][NEUTRAL] OK, bye.