AccountId: 011433970860
ContactId: 6cbec596-186f-44a2-97b9-f61952ad4577
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 517210 ms
Total Talk Time (AGENT): 164736 ms
Total Talk Time (CUSTOMER): 123459 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/6cbec596-186f-44a2-97b9-f61952ad4577_20250425T15:46_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]. My name is [PII] and I'm calling from the dental office for dental eligibility and benefits on a recorded line. Could you please help me with that?
[AGENT][POSITIVE] Yes, I can help you with eligibility and benefits today. Do you have the policy number?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, I do have here. It's uh 026-05937.
[AGENT][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, [PII], what's a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Hello, are you there?
[CUSTOMER][NEUTRAL] Oh, I'm so sorry. It's uh [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you. And then what's the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] That will be for [PII], [PII].
[AGENT][NEUTRAL] OK, and it looks like the policy is currently active. The effective date.
[AGENT][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, the effective date is [PII].
[CUSTOMER][NEUTRAL] And how about their group name and group number?
[AGENT][NEUTRAL] Please
[AGENT][NEUTRAL] So the group number is 17626 and that's Universal Trucking Stevens Transport.
[CUSTOMER][NEUTRAL] Universal and then the second one?
[AGENT][NEUTRAL] Trucking.
[CUSTOMER][NEUTRAL] tracking
[AGENT][NEUTRAL] Stevens.
[AGENT][NEUTRAL] Transport.
[CUSTOMER][NEUTRAL] And just to confirm the, uh-huh, effective date, you said it was on [PII], right? Not [PII]?
[AGENT][NEUTRAL] Yes, it is [PII].
[CUSTOMER][NEUTRAL] And is this a calendar plan or benefit you?
[AGENT][NEUTRAL] Looks like this is a calendar year plan.
[CUSTOMER][NEUTRAL] Excuse me. Is there any message your class or we repeat it?
[AGENT][NEUTRAL] OK, let me pull up the general benefits just really quick.
[AGENT][NEGATIVE] OK. And there is a missing tooth cloth.
[CUSTOMER][NEUTRAL] And how about the waiting period?
[AGENT][NEUTRAL] So it looks like the waiting period for preventative expenses, there is none.
[AGENT][NEUTRAL] For basic, there is no waiting period and for major expenses, there is a 12 month waiting period.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For me
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And also, if you could also provide me the annual maximum and deductibles.
[AGENT][POSITIVE] Yes, I can.
[AGENT][NEUTRAL] So this is not a guaranteed payment, it's just a verification of coverage. So it looks like the calendar year deductible is $50 per covered insured, up to $150 per family, and deductible does not apply to preventative expenses.
[AGENT][NEUTRAL] The calendar year max is 1500 per covered insured.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And is there any auto coverage?
[AGENT][NEUTRAL] And sorry, what did you say?
[CUSTOMER][NEUTRAL] Orthodontics coverage.
[AGENT][NEUTRAL] So orthodontic treatment is not covered.
[CUSTOMER][NEGATIVE] Not cover
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And has the patient used them use anything from the
[CUSTOMER][NEUTRAL] Are you mind?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEGATIVE] No, the patient has not used any benefits this year.
[CUSTOMER][NEUTRAL] And for the crowns, are they paid on as the date?
[AGENT][NEUTRAL] So we do not coordinate benefits.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So you can provide me the benefits verbally?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Would you also like the fact
[CUSTOMER][NEUTRAL] And how about the insurance for?
[AGENT][NEUTRAL] Sorry, would you like the dental fax back?
[CUSTOMER][NEUTRAL] Yes, please, if you could, please. Mhm.
[CUSTOMER][NEUTRAL] And how about the history, will that be available in the fax?
[AGENT][NEUTRAL] No, the history will not. It will just state the benefits for this policy.
[CUSTOMER][NEUTRAL] And how about the downgrades?
[AGENT][NEUTRAL] We do not determine downgrades.
[CUSTOMER][NEUTRAL] OK, if you could send me the fax back please.
[AGENT][NEUTRAL] Yes, ma'am. Uh, can I have your fax number, please?
[CUSTOMER][NEUTRAL] That'll be [PII].
[AGENT][POSITIVE] OK, perfect.
[AGENT][POSITIVE] And I will send this right over to you. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Um, if you could help me with one last patient here, [PII].
[AGENT][NEUTRAL] Yeah, of course. Uh, do you have that policy number?
[CUSTOMER][NEUTRAL] Yes. It's 02518124.
[AGENT][NEUTRAL] OK, and then patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] That'll be for [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and it looks like this policy is no longer active as of [PII].
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. So there's no other active pants?
[AGENT][NEUTRAL] No, ma'am. I just checked. There's no active, no more active policies per patient.
[CUSTOMER][NEUTRAL] OK. And just confirm, uh, it won't take time, right, for the fax to reach?
[AGENT][NEUTRAL] It only takes about 3 minutes.
[CUSTOMER][POSITIVE] OK, then that'll be it. And I'm done here for you. Thank you very much, [PII], for your time and help. I really appreciate it. You have a wonderful day ahead.
[AGENT][POSITIVE] Yeah, you're welcome. You too. Thanks for calling APL, Kim.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you. Bye.