AccountId: 011433970860
ContactId: 578e4144-41dd-46cc-810d-a2ff0347eee6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203110 ms
Total Talk Time (AGENT): 118553 ms
Total Talk Time (CUSTOMER): 67714 ms
Interruptions: 0
Overall Sentiment: AGENT=3.1, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/578e4144-41dd-46cc-810d-a2ff0347eee6_20241231T14:36_UTC.wav
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[AGENT][POSITIVE] Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes, I was trying to verify eligibility and benefits.
[AGENT][POSITIVE] It would be my pleasure to assist you. May I ask your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, [PII] and what is a good call back number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And the policy number for the patient, please.
[CUSTOMER][NEUTRAL] Yes, it gave 02559886.
[AGENT][NEUTRAL] Thank you, [PII] and the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, let's see, [PII] [PII].
[AGENT][POSITIVE] All right, thank you. It'd be my pleasure to assist you with the eligibility for [PII]. I am showing that his policy is active with the effective date of [PII]. Anything else I can help you with?
[CUSTOMER][NEUTRAL] Yes, could you please tell me um the group number?
[AGENT][NEUTRAL] Sure. The group number is 70055.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK perfect and then um could you please tell me his maximum and deductible?
[AGENT][NEUTRAL] Sure, now I do have a breakdown that I can fax to you if you would prefer that. It's got all the policy, uh, the calendar year max, deductibles, frequencies, limitations, billing information, and the procedures listed that are covered.
[CUSTOMER][NEUTRAL] Uh, our fax is actually down at the moment.
[AGENT][NEUTRAL] OK, not a problem. So all benefits given over the phone is a verification of coverage, not a guarantee of payment. He has a calendar year max of $500. This is a limited dental policy does not cover major procedures.
[CUSTOMER][NEUTRAL] OK, got you, and then what would be his co-insurance?
[AGENT][NEUTRAL] For preventive, we pay 100%, for radiographs FMX basic expenses and basic restorative expenses, we pay 80%.
[CUSTOMER][NEUTRAL] OK and you said there's no major coverage?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, got you. Is there any missing, sorry.
[AGENT][NEUTRAL] That does
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] I was just gonna say that major services that does include oral surgery, prosthodontic repairs, any periodontal services or endodontic services.
[CUSTOMER][NEUTRAL] Oh got you OK uh alrighty, is there any missing tooth cloths or waiting period?
[AGENT][NEUTRAL] There's no waiting period, but there is some missing tooth claws.
[CUSTOMER][NEUTRAL] OK, and then does he have any history that could affect frequencies?
[AGENT][NEUTRAL] Nope.
[AGENT][NEUTRAL] Excuse me, no history and no deductible med. Sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect. Alright, perfect. That was all I needed. Thank you so much. Can I just have a reference number please?
[AGENT][POSITIVE] I can see your reference number would be my name and today's date, and I spell my name [PII], and it was a pleasure to assist you with that breakdown today. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Uh, no, ma'am, that would be all, thank you.
[AGENT][POSITIVE] Well, thank you for calling APL. I hope you have a wonderful day and a very happy [PII].
[CUSTOMER][POSITIVE] Thank you you too bye.
[AGENT][POSITIVE] Thank you bye bye.