AccountId: 011433970860
ContactId: 5a34ed86-cd70-427a-bfc2-781918869fe2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240759 ms
Total Talk Time (AGENT): 94783 ms
Total Talk Time (CUSTOMER): 77152 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/5a34ed86-cd70-427a-bfc2-781918869fe2_20250523T19:14_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, um, this is [PII] from Trinity Dental. I have a quick question on one of our patients policies, please.
[AGENT][NEUTRAL] OK, well, I'll be able to help you with the policy. And from my notes, can you spell your first name for me please and provide a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII]
[AGENT][NEUTRAL] And a contact number and the member's policy number?
[CUSTOMER][NEUTRAL] Um, that is.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the um do you need the patient ID number?
[AGENT][NEUTRAL] Yes, the policy number.
[CUSTOMER][NEUTRAL] Mhm 02356209.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Um, yes, that is for Mr. [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And how may I assist you today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, on this plan, I just need to know the, if there's a waiting period, um, the maximum amount, and if there's a deductible or percentages for the treatment.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Alright, so the policy is active for [PII] it's been active since [PII]. Let me see what type of plan they have. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Be poquito.
[AGENT][NEUTRAL] Just waiting for the fax back. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, so the calendar, you're wanting to go over this or you want a copy of this?
[CUSTOMER][NEUTRAL] Um, I can go over it. I just need a couple of things, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yep, do you have a max amount for this plan?
[AGENT][NEUTRAL] Yes, it's $1500 per calendar year.
[CUSTOMER][NEUTRAL] OK, have they used any of it for this year?
[AGENT][NEUTRAL] Um, let's see, hold on one moment.
[AGENT][NEGATIVE] Um, no, they have not used any of the max or met the $50 deductible.
[CUSTOMER][POSITIVE] OK, good.
[CUSTOMER][NEUTRAL] And um what about the waiting period?
[AGENT][NEUTRAL] There's a 12-month waiting period, um, but the policy has um satisfied that.
[CUSTOMER][NEUTRAL] OK, good. And the last thing that I um that I need would be the percentages for preventative, basic and major.
[AGENT][NEUTRAL] OK. Um, so preventative is covered at 100%?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Radio graphs, um, SMX, basic, and basic restorative are all covered at 80%.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Major expenses are covered at 40%.
[AGENT][NEUTRAL] And major for us includes endodontic, perdontic, prosodontic, and oral surgery.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get a reference number for the call, please?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. Again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much for your help today.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] That'll be all thank you.
[AGENT][POSITIVE] Alright, thanks for calling API have a great weekend bye bye.
[CUSTOMER][POSITIVE] You too thank you bye.