AccountId: 011433970860
ContactId: 57aad524-0b4e-4780-bbad-ebb9b73ad86e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 465070 ms
Total Talk Time (AGENT): 190987 ms
Total Talk Time (CUSTOMER): 133031 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/57aad524-0b4e-4780-bbad-ebb9b73ad86e_20250204T22:24_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was calling to get um eligibility and benefit information for a patient.
[AGENT][NEUTRAL] OK, I can help you with that. Could I get your name and a callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. Callback number is [PII] option two.
[AGENT][NEUTRAL] OK, thank you. And the policy number you're calling on?
[CUSTOMER][NEUTRAL] It is 01375412.
[AGENT][NEUTRAL] The patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you, and you said you are calling for uh uh benefits and eligibility?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I do show.
[AGENT][NEUTRAL] The the policy been effective since [PII], it's still active. And would you like me to send over uh a dental fax of the benefits?
[CUSTOMER][NEUTRAL] Yes, but would you mind um going over it over the phone with me?
[AGENT][NEUTRAL] Sure, let me get that pulled up really quick hold one moment please.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh, here we go. I don't know how to pull this up.
[AGENT][POSITIVE] Enhanced based.
[AGENT][NEUTRAL] OK, I don't see none talking I know so and I know select.
[AGENT][NEUTRAL] What?
[AGENT][NEUTRAL] OK, and I.
[AGENT][NEUTRAL] B
[AGENT][NEUTRAL] So it has to be this one.
[AGENT][NEUTRAL] You are low, you got high.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] UTB OK.
[AGENT][NEUTRAL] OK, thank you for holding. I do apologize for the wait, uh, and I have those benefits pulled up and please be advised verifying benefits is not guaranteed payment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let me put some information in really quick.
[AGENT][NEUTRAL] OK, and you have some questions on the policy?
[CUSTOMER][NEUTRAL] Yes, can you um tell me what the group name is?
[AGENT][NEUTRAL] Oh, let's see.
[AGENT][NEUTRAL] The group name is Universal Trucking.
[AGENT][NEGATIVE] Genu Transportation.
[CUSTOMER][NEUTRAL] Universal.
[CUSTOMER][NEUTRAL] Universal Trucking Genix Transportation.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and um is the group number 15395?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, um, and what is the um network or fee schedule?
[AGENT][NEUTRAL] Uh, it will be usual and customary.
[CUSTOMER][NEUTRAL] OK, give me one second.
[CUSTOMER][NEUTRAL] American uh.
[CUSTOMER][NEUTRAL] And the insurance name is it American Public Life?
[AGENT][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what is the um claims address?
[AGENT][NEUTRAL] Mailing address for claims is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and is there a deductible for this plan?
[AGENT][NEUTRAL] Mm let's see.
[AGENT][NEUTRAL] There is a $50 deductible per person, one thing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Has anything been met year to date?
[AGENT][NEUTRAL] Let me check that.
[AGENT][NEUTRAL] I show, uh, he has not met any of his deductible nor used any of his benefits for [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, what's the annual maximum?
[AGENT][NEUTRAL] The annual maximum is $1500.
[CUSTOMER][NEUTRAL] Alrighty and let's see.
[CUSTOMER][NEUTRAL] Let's see, let's see, alrighty, and then the coverage for diagnostic, basic and major, is it, uh, can you give me the percentage for that?
[AGENT][NEUTRAL] For basic, it is 80%.
[AGENT][NEUTRAL] Of the UCR.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] And is major services covered?
[AGENT][NEUTRAL] Major is 40% of the UCR.
[CUSTOMER][NEUTRAL] 40%. OK. And endoonics, periodontics, and oral surgery, is that covered?
[AGENT][NEUTRAL] That is covered under the, uh, at 40% of the UCR.
[CUSTOMER][NEUTRAL] OK, and what about dentures, bridges, and crowns?
[AGENT][NEUTRAL] Mm let's see.
[AGENT][NEUTRAL] Crowns and bridges are covered uh once every 7 years per tube. Uh, partials and dentures are covered once every 5 years.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes, I'm sorry, you said dentures and partials are once every 5 years?
[AGENT][NEUTRAL] Oh, that's
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][POSITIVE] Perfect, I think that is everything that I need. Thank you so much. And then you are sending a fax as well. Oh yes, what's the fee schedule?
[AGENT][NEUTRAL] And would you like to see schedule? OK, yeah, let me.
[AGENT][NEUTRAL] Uh, it's all, it's all gonna be faxed to you, the, uh.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] The uh procedures, covered, uh, procedures.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] And there's frequencies on there as well, right on that fact.
[AGENT][NEUTRAL] Yes, it is. Yes, ma'am. Mhm.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And what is the fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And am I sending that to your attention?
[CUSTOMER][NEUTRAL] Yes, uh [PII].
[AGENT][POSITIVE] OK. It is on its way. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Nope, that is it. Thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. You have a wonderful day. Thank you for calling APO. Bye bye.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] Bye bye.