AccountId: 011433970860
ContactId: 74045174-efdd-4e28-8344-50f8f4bd51c6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 344000 ms
Total Talk Time (AGENT): 108620 ms
Total Talk Time (CUSTOMER): 92434 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/74045174-efdd-4e28-8344-50f8f4bd51c6_20250304T21:11_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 rental office for dental eligibility and benefits on a recorded line. Could you please help me with that?
[AGENT][NEUTRAL] Yes, [PII], I can help you with dental benefits. Uh, can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Uh sure, that would be [PII].
[AGENT][NEUTRAL] OK, and then what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Just bear with me a moment here it's loading, just bear with me a moment.
[CUSTOMER][NEUTRAL] OK. And that is the Downtown SD Modern Dentistry?
[AGENT][NEUTRAL] OK, thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, [PII], [PII].
[AGENT][NEUTRAL] OK, and what is [PII]'s policy number?
[CUSTOMER][NEUTRAL] Uh, it's uh 123.
[CUSTOMER][NEUTRAL] 5 consecutive zeros. 249-7253.
[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 of the policy is [PII]. And if you give me your fax number, I'll send you a fax back with the complete benefit breakdown and fee schedule.
[CUSTOMER][NEUTRAL] Oh, if you couldn't, you can, you can't provide me the benefits of the phone verbally?
[AGENT][NEUTRAL] I'm sorry, what did you just say?
[CUSTOMER][NEUTRAL] If you could provide me the benefits over the phone verbally.
[AGENT][POSITIVE] Oh, OK. All right. I can do the best that I can, that's for sure.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And I have their group name and group number please.
[AGENT][NEUTRAL] OK, the group number is 70052.
[AGENT][NEUTRAL] The group name is Oxford Global Resources.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you. And is there any missing calls or waiting period?
[AGENT][NEUTRAL] Let me check. I'm pulling up that fax back real quick.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes, they do have a missing tooth clause.
[CUSTOMER][NEUTRAL] OK, and the waiting period?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] There's no waiting period.
[CUSTOMER][NEUTRAL] OK. So I could please provide me the annual maximum and deductible.
[AGENT][NEUTRAL] The maximum and this is just to verify benefits. It's not a guarantee of payment.
[AGENT][NEUTRAL] The maximum per calendar year is $500 and the calendar year deductible is $50.
[CUSTOMER][NEUTRAL] Is there any family deductible?
[AGENT][NEUTRAL] No, well, up to $150 for a family.
[CUSTOMER][NEUTRAL] And is there any auto coverage?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK. And also, how about the coinsurance for preventive basic and me?
[AGENT][NEUTRAL] Basic is 80% of the allowable.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And preventative is 100%.
[CUSTOMER][NEGATIVE] There's no major coverage.
[AGENT][NEGATIVE] No major coverage.
[CUSTOMER][NEUTRAL] And is there any history in files that might affect their frequency?
[AGENT][NEUTRAL] Let me look for you.
[AGENT][NEUTRAL] If you have a procedure code I can check it for you.
[CUSTOMER][NEUTRAL] 0 to 10.
[CUSTOMER][NEUTRAL] 0274.
[AGENT][NEUTRAL] OK, let me look real quick.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] I do not see that either one of those procedures has been done in the year of [PII] or in the year of [PII].
[CUSTOMER][POSITIVE] OK. So that'll be it then. I am done here. So, yeah, thank you very much, [PII], for your time and help. I really appreciate it. You have a wonderful day.
[AGENT][POSITIVE] You have a great day too, and thank you for calling APL. We appreciate you calling Miss [PII].
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] All right bye bye.