AccountId: 011433970860
ContactId: 71da3aa3-57bc-4588-84b8-85b72cdcbdb7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 247660 ms
Total Talk Time (AGENT): 89548 ms
Total Talk Time (CUSTOMER): 133530 ms
Interruptions: 8
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/71da3aa3-57bc-4588-84b8-85b72cdcbdb7_20250310T13:38_UTC.wav
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[CUSTOMER][NEUTRAL] OK, that's fine. I'll just make make a copy of your driver's license and fill out some paper card for me.
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey [PII], I need to get a breakdown my patient's benefits. It's [PII] callback number is [PII].
[AGENT][NEUTRAL] May I have your name and a callback number?
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] 02589585
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And would you like a fax back for this member?
[CUSTOMER][NEUTRAL] Um, can I go ahead and get it verbally? I need a full breakdown.
[AGENT][NEUTRAL] OK, what information are you needing?
[CUSTOMER][NEUTRAL] Hey there how are you?
[AGENT][NEUTRAL] OK, what information are you needing just the member's deductibles?
[CUSTOMER][NEUTRAL] Preventative basic.
[CUSTOMER][NEUTRAL] Yeah, deductible.
[CUSTOMER][NEUTRAL] Maximum
[CUSTOMER][NEUTRAL] And what percentage coverages are covered up?
[CUSTOMER][NEUTRAL] When you sign in I'll need your driver's license and your credit card.
[CUSTOMER][NEUTRAL] Um, I mean we
[AGENT][NEUTRAL] So in regards to this member, verification of coverage does not guarantee the payment of the claim. For the calendar year max, the member has up to $1500 per calendar year. The calendar year deductible, the member does have up to $50 per covered insured, and then the deductible does not apply to the preventative care.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Oh, I love it.
[CUSTOMER][NEUTRAL] Ok.
[AGENT][NEUTRAL] And for the preventative, we will pay up to 100% of UCR and for the basic expenses and restorative expenses, we will pay up to 80% of UCR.
[CUSTOMER][NEUTRAL] Did they just call and let you know it's in or did they have to make an appointment.
[CUSTOMER][NEUTRAL] Uh, no, we just have to get to root canals fall under the basic?
[AGENT][NEUTRAL] May I have that procedure code, please?
[CUSTOMER][NEUTRAL] 3330.
[CUSTOMER][NEUTRAL] any changes to your insurance.
[CUSTOMER][POSITIVE] OK, OK, sure thing, we'll get it from you if you wanna give us just a few minutes.
[AGENT][NEUTRAL] That is covered up under the endodonics and let me pull that up for you.
[CUSTOMER][POSITIVE] Yeah I've got everything so yeah you're good um let me um.
[AGENT][NEUTRAL] That is 40% of UCR.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright, what about extractions? I have two codes on that [PII].
[CUSTOMER][NEUTRAL] I'm sorry, [PII] and [PII].
[AGENT][NEUTRAL] The [PII] and [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Either way, left or right.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] The [PII] is listed up under the basic expenses and then the [PII].
[CUSTOMER][NEUTRAL] Have you been here before? OK.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Um, he is.
[CUSTOMER][NEUTRAL] Are you having a problem with the pain?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] What you guys are.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Like I, I get her.
[AGENT][NEUTRAL] That is listed up on the oral surgery expenses which is up to the 40%.
[CUSTOMER][NEUTRAL] Alright, and can you go ahead and send me a fax? I'll get the rest off that.
[AGENT][NEUTRAL] May I have the fax number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. And is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] No, ma'am, that's it.
[AGENT][POSITIVE] I do wanna thank you so much for calling American Public Life. Have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Thank you bye.