AccountId: 011433970860
ContactId: 60073506-8e5d-4baa-85ec-1bd6cdf54933
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 319660 ms
Total Talk Time (AGENT): 139082 ms
Total Talk Time (CUSTOMER): 126697 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/60073506-8e5d-4baa-85ec-1bd6cdf54933_20250214T13:43_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Uh, hi, this is [PII] from dental office, checking eligibility and benefits for dental.
[AGENT][POSITIVE] OK, [PII], I'll be glad to help you. Go and give me a good policy number, please, sir.
[CUSTOMER][NEUTRAL] Can you repeat once again?
[AGENT][NEUTRAL] I need the member's policy number.
[CUSTOMER][NEUTRAL] Yeah, it's uh 02451314.
[AGENT][POSITIVE] All right, [PII], thank you so much for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please, sir.
[CUSTOMER][NEUTRAL] Yeah, it would be.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alrighty, thank you so much for all that information, [PII]. Now what's your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So yeah, the patient's name would be uh [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you, [PII], for all that information. Looks like he is the insured on this dental plan. I do show the original effective date is [PII]. Patient is current and active, but I must advise that verification of coverage is not a guarantee of payment on a claim, but you did say you want to pay back a benefit. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, I don't need a fax that. I just need some information.
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] OK, how can I help you?
[CUSTOMER][NEUTRAL] Yeah, can you please tell me the group name and group number?
[AGENT][NEUTRAL] I sure can. Let me get over to that screen. Group number is 70087.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Group name is Partners Personnel Management.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] OK, and this is a calendar year plan, am I right?
[AGENT][NEUTRAL] That is correct calendar year.
[CUSTOMER][NEUTRAL] OK. And annual maximum is $500 am I correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And how much is remaining from that?
[AGENT][NEUTRAL] Let's see if he has any claims. Let's see.
[AGENT][NEUTRAL] not have any claims for [PII] at all.
[CUSTOMER][NEUTRAL] OK, so $500 remaining is uh $500 is maximum and remaining as well $500 am I right?
[AGENT][POSITIVE] Yes, that is correct as of today.
[CUSTOMER][NEUTRAL] OK. And what about deductible?
[AGENT][NEUTRAL] And I'm sorry, what was that?
[CUSTOMER][NEUTRAL] Is it $50?
[AGENT][NEUTRAL] Um, yes, deductible is 50. Yes, 50.
[CUSTOMER][NEUTRAL] Uh, individual deductible.
[CUSTOMER][NEUTRAL] And uh does it met or not met?
[AGENT][NEUTRAL] No, nothing's me. We don't have any claims.
[CUSTOMER][NEUTRAL] OK. And uh for orthodontics, uh, orthodontic treatment is covered or not covered for this patient?
[AGENT][NEGATIVE] Not covered. No major coverage either.
[CUSTOMER][NEUTRAL] OK. Can you please throw
[CUSTOMER][NEUTRAL] Thank you. And can you please provide me the history for 0120021002741110?
[AGENT][NEUTRAL] Well, it looks like he had all both of those codes on [PII].
[CUSTOMER][NEUTRAL] Uh, can you repeat once again the date of service?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] for all of these four quotes, am I correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And um this floor, right? 1206 and 4341 is covered or not covered?
[AGENT][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just a second.
[AGENT][NEUTRAL] Sure, [PII].
[CUSTOMER][NEUTRAL] And can you please tell me that uh provider is uh
[CUSTOMER][NEUTRAL] In network or out of the network?
[AGENT][NEUTRAL] Uh, no, sir, but I can give you [PII]'s, uh, phone number and you can call over and see if you're in network or not, [PII], would you like that number?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Uh, OK, it's fine. Can you please spell out your name?
[AGENT][NEUTRAL] My name is spelled [PII] yes, [PII].
[CUSTOMER][NEUTRAL] OK. What's the reference number?
[AGENT][NEUTRAL] We do not give reference number [PII], but you can use my name in today's date if you need to do so, OK? And is that all that I can help you with?
[CUSTOMER][NEUTRAL] OK, so the reference number is your name and the date.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, love. Thank you for helping me. Have a nice day. Bye for now.
[AGENT][POSITIVE] You as well. Thanks for calling APL, [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.