AccountId: 011433970860
ContactId: 72742d8e-e87f-47cb-99c1-45baccb162ac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194279 ms
Total Talk Time (AGENT): 85759 ms
Total Talk Time (CUSTOMER): 70131 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/72742d8e-e87f-47cb-99c1-45baccb162ac_20250507T17:22_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. This is [PII] here calling on behalf of the dental office to check eligibility and benefits for a few patients, uh, for one patient, I'm so sorry, on a recorded line. Can you help me with that, please?
[AGENT][POSITIVE] Yes, I'll be more than happy to assist you um with the eligibility and benefits. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. The callback number is gonna be [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] The patient member ID number and that is gonna be
[CUSTOMER][NEUTRAL] 02457480.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure. The patient name is gonna be [PII] and then the date of birth is gonna be [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing that the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And um did you need a copy of the fax back or you have particular questions about it?
[CUSTOMER][NEUTRAL] Just a few specific set of questions that I want to know about. So, uh, can you first please help me with the group name and the group number, please?
[AGENT][NEUTRAL] Sure, hold on one moment.
[CUSTOMER][POSITIVE] That's fine. You can take your time.
[AGENT][NEUTRAL] The group number is 70,030.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The group name is Creative Circle LLC.
[CUSTOMER][NEUTRAL] Got it. And what will be the annual maximum the deductible on the plan?
[AGENT][NEUTRAL] The calendar year max is $500 per insured.
[AGENT][NEUTRAL] The deductible is $50 per person up to $150 per family.
[CUSTOMER][NEUTRAL] OK. And then is there anything you and is the deductible being met?
[AGENT][NEUTRAL] Let's see, hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Um, he has not used any of the max or met the deductible.
[CUSTOMER][NEUTRAL] So, still the $500 is the remaining. OK, got it. And what are the co-insurance on the plan?
[AGENT][NEUTRAL] The policy covers preventative at 100%, radiographs and FMX, basic expenses and basic restorative all at 80%. There's no major coverage. Major for us includes endodontic, periodontic, prosodontic, and oral surgery codes.
[CUSTOMER][NEUTRAL] Got it. And uh, and then what will be the call reference number for this one?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Oh, got it. Thank you so much for your help today. I'm done with my questions. Thank you.
[AGENT][POSITIVE] You're welcome. [PII], was there anything else I can help you with today?
[CUSTOMER][POSITIVE] Oh no, I'm done with my questions, and I thank you so much for your help today once again.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Bye bye.
[CUSTOMER][POSITIVE] Bye. Take care.