AccountId: 011433970860
ContactId: 592f80f4-9096-4d04-9fa2-ae4316cea536
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 368570 ms
Total Talk Time (AGENT): 126483 ms
Total Talk Time (CUSTOMER): 164514 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/592f80f4-9096-4d04-9fa2-ae4316cea536_20250307T15:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Cleveland Dental. I was calling to find out if this patient's active for uh Monday's data service, so this upcoming Monday.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with benefits. Um, first, I'll need a callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Of course. That would be [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 5
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Uh, policy. OK. 02.
[CUSTOMER][NEUTRAL] 33
[CUSTOMER][NEUTRAL] 04
[CUSTOMER][NEUTRAL] 33.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active.
[CUSTOMER][NEUTRAL] So the, the, the policy is still active. Just give me one second. Uh, I wanted to make sure that we are in network with this plan cause this is the first plan I've seen. Um, is it possible that we can check if we are in network?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Well, we work with our providers.
[AGENT][NEUTRAL] So, yes, you're in network.
[CUSTOMER][NEUTRAL] Mhm. So.
[CUSTOMER][NEUTRAL] You guys don't have a specific, um,
[CUSTOMER][NEUTRAL] What is it called?
[CUSTOMER][NEUTRAL] Uh, like preferred dentist.
[AGENT][POSITIVE] Get a free schedule.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] You don't, you don't have any. All right. Um, then, can I ask what fee schedule you guys use?
[AGENT][NEUTRAL] Um, yes, ma'am. Let me pull that up for you. And actually for the fee schedule and the fax back, I can fax that to you.
[CUSTOMER][POSITIVE] Of course, I would love that. I can give you our fax number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, what's your fax number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 440
[CUSTOMER][NEUTRAL] 287
[CUSTOMER][NEUTRAL] 16
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so that's attention, [PII] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. You should receive it in about 10 minutes. I just sent it. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] OK, this is the, you sent over the fee schedule, is that correct?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] All right. Can I also have a fax over of the benefits for [PII]?
[AGENT][NEUTRAL] Yes, ma'am. That's what I'm sending you the uh benefits and the fee schedule for Mr. [PII].
[CUSTOMER][POSITIVE] All right. Thank you so much. Um, can I just go over their, uh, what is it called? Their plan ID?
[CUSTOMER][NEUTRAL] With you quickly. Is it 02055106?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Is that correct?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] No, it's actually the policy number that you gave me, the 02330433.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am. That's the policy number, the member ID and the policy number.
[CUSTOMER][NEUTRAL] They're the same thing. All right, so this is not the correct plan. This was the plan that I have on file so I just wanna make sure that it's correct, uh.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] But that's all right. Can I, is the plan name American Public Life, or does it have a specific name or it's just the same for everything?
[AGENT][NEUTRAL] It's American Public Life. Mhm.
[CUSTOMER][NEUTRAL] Mhm. All right. Uh.
[CUSTOMER][NEUTRAL] Uh, can I know their deduct if they have, uh, deductible in their maximum, their annual maximum, or is this all gonna be in the?
[AGENT][NEUTRAL] Yes, ma'am. It's uh
[AGENT][NEUTRAL] Yes, it's on the fax bag, but it's a calendar year plan, um, $1500 maximum with a $50 deductible.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So $500 maximum with a $50 deductible. Is there a plan deductible?
[AGENT][NEUTRAL] Well, no, the
[CUSTOMER][NEUTRAL] Is there a family deductible?
[AGENT][NEUTRAL] The calendar year maximum is 1500 per um
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] One problem
[AGENT][NEUTRAL] Yeah, per member.
[AGENT][NEUTRAL] $1500 per calendar year, but there's a $50 deductible that needs to be met.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Per individual as well.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh, is there an annual deductible as well?
[AGENT][NEUTRAL] Yes, it's $50.
[CUSTOMER][NEUTRAL] I mean family develop.
[CUSTOMER][NEUTRAL] So the annual family deductible is $150?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, it is.
[CUSTOMER][POSITIVE] All right, thank you so much. All right, I'm gonna just create that and I'll be waiting on the fax. Thank you so much.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] OK, thank you again for calling me.
[CUSTOMER][NEUTRAL] Uh, can I please just
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And a reference number for this call?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. It's spelled [PII] last [PII], and today's date. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] OK, thank you again, [PII], for calling APL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] Mhm.