AccountId: 011433970860
ContactId: 699c4ac2-cb5e-4ff4-9e33-82cbb84f4c79
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228490 ms
Total Talk Time (AGENT): 106521 ms
Total Talk Time (CUSTOMER): 86808 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/699c4ac2-cb5e-4ff4-9e33-82cbb84f4c79_20250320T13:58_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm calling from Metropolitan Resins dental office, and I was just wondering if I get the um breakdown of the dental benefits for my patient.
[AGENT][NEUTRAL] Sure, I can assist you with that. Can I have a callback number for you and that policy number, [PII]? You did say your name was [PII].
[CUSTOMER][NEUTRAL] Nope, it's [PII].
[AGENT][NEUTRAL] [PII], I, I do apologize. I changed name.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Our phone number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] The policy number is 14774.
[AGENT][NEUTRAL] It's not long enough to be a policy number. It should say policy or certain number on the card?
[CUSTOMER][NEUTRAL] Um, she would just read it to me over the phone. Um, I have a certificate number is 025.
[CUSTOMER][NEUTRAL] 60623.
[AGENT][NEUTRAL] And what is this member's name and date of birth?
[CUSTOMER][NEUTRAL] Um, the member's name.
[CUSTOMER][NEUTRAL] Like the policy holder or the patient?
[AGENT][NEUTRAL] The patient
[CUSTOMER][NEUTRAL] The patient is [PII] and her date of birth is.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] Thank you. This policy has been active since.
[AGENT][NEUTRAL] [PII] and is currently active En. Joy has a maximum benefit amount of $1500 per calendar year with a $50 deductible per insured up to $150 per family, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Is the deductible for basic and major or for all services?
[AGENT][NEUTRAL] The deductible goes towards everything but preventative services.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, and then can I um have the frequency limitations as well, please?
[AGENT][NEUTRAL] So there is a 12 month waiting period on all major services which does not exist until [PII]. Um, I'm not sure. Do you, you can provide me a code and I can give you the frequencies.
[CUSTOMER][NEUTRAL] Um, OK, so
[CUSTOMER][NEUTRAL] And so is preventative, is it covered at 100% or?
[AGENT][NEUTRAL] Mhm. It's covered at 100%. Basic at 80, 40.
[AGENT][NEUTRAL] And I can send you a fax back of the dental schedule if you would like.
[CUSTOMER][POSITIVE] Yeah, that would be great and then um it's like the mailing address and then.
[AGENT][NEUTRAL] The mailing address will be addressed to [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], but this is listed on the very first page of the dental schedule that I'm gonna send over for you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] What is your fax number?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I have [PII].
[CUSTOMER][NEUTRAL] Yep, yes, and then does it have the payer ID on it as well?
[AGENT][NEUTRAL] It does, it's 60801.
[AGENT][NEUTRAL] She has no history on file, nor has she utilized any of her benefits for [PII].
[CUSTOMER][NEUTRAL] OK, alright, so just 12 month waiting period, 12 months, I don't think so.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, [PII]? Yes, 12 month waiting period on all major services.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][POSITIVE] OK, all right, thank you so much I appreciate your help.
[AGENT][POSITIVE] You're welcome, [PII]. I'm gonna send this over for you. Thanks for calling APL and have a great day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thanks you too alright bye bye.
[AGENT][POSITIVE] Thanks. Goodbye.