AccountId: 011433970860
ContactId: 6aee03b5-476c-44b7-870a-a39b5abf5d89
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 416500 ms
Total Talk Time (AGENT): 110358 ms
Total Talk Time (CUSTOMER): 72544 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/6aee03b5-476c-44b7-870a-a39b5abf5d89_20250331T18:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I want to check eligibility for one patient.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, I can help you with eligibility. Can you please give me.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Could you please give me your name and your callback number?
[AGENT][NEUTRAL] And I can check the eligibility.
[CUSTOMER][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] [PII] and then the callback number is [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] It is [PII]. The date of birth is [PII], and then the ID number is 0256.
[CUSTOMER][NEUTRAL] 3094
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy and her effective date is [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Is there any way I can get a benefit breakdown?
[AGENT][POSITIVE] Absolutely. What is your fax number?
[CUSTOMER][NEUTRAL] It is [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, Ms. [PII], I'm gonna put you on a brief hold while I get that fax ready for you and I'll be right back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, Ms. [PII]. I got that fax back on its way to you now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] OK thank you.
[CUSTOMER][NEUTRAL] Uh yes, I do have a few questions.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] OK, and what are the questions that you may have?
[CUSTOMER][NEUTRAL] Um, for this one I wanna check if my provider was in the routing network.
[AGENT][NEUTRAL] So, um, they can use any, uh, dental facility that they want to use. It's paid based off of UCR.
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][NEUTRAL] OK, even if it was in or out of nowhere, correct?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, and then do you accept releases assignment of benefits?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] You the assignment of benefits then it'll be paid to the patient. If you don't check the assignment of benefits, then it'll be paid to the provider.
[CUSTOMER][NEUTRAL] Oh sorry, it was cutting out. Do you mind repeating that for me?
[AGENT][NEUTRAL] If you check the pay uh, the assignment of benefits, it'll be paid to the patient, but if you don't check it then it'll be paid to the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then uh for oral surgery, does it go through medical or dental?
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] This policy only has basic and preventative. It does not have um major.
[AGENT][NEUTRAL] Coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And do they have a waiting period?
[AGENT][NEUTRAL] No, ma'am, on the fax back that you get, it'll have that information for you um there's no waiting period.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK then if I can use to get a reference number?
[AGENT][NEUTRAL] Yes ma'am. You can use my name, [PII] in today's date.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're so very welcome, Ms. [PII]. Is there anything else I can help you with before we go?
[AGENT][NEUTRAL] Any other questions? OK.
[CUSTOMER][NEUTRAL] No ma'am.
[CUSTOMER][POSITIVE] Yes ma'am that'll be all.
[AGENT][POSITIVE] Thank you for calling APL you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye, ma'am.