AccountId: 011433970860
ContactId: 75b8d9ac-1a67-4d54-8379-22e910a2f701
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 444859 ms
Total Talk Time (AGENT): 114980 ms
Total Talk Time (CUSTOMER): 186189 ms
Interruptions: 3
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/75b8d9ac-1a67-4d54-8379-22e910a2f701_20250619T19:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. My name is [PII] calling on behalf of dental office to check eligibility and benefits for 2 patients on a recorded line.
[AGENT][NEUTRAL] OK, I can check eligibility and benefits for you. Uh, you said your name was [PII]?
[CUSTOMER][NEUTRAL] Hi, is this [PII].
[CUSTOMER][NEUTRAL] Oh yes. And what's your name?
[AGENT][NEUTRAL] OK. [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] And can I get a good call back number from you in case we're disconnected?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] Sure, that is 02576415.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] Member's name is uh [PII] and the last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. So this policy is active. Effective date was [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And if you'd like I can send you a fax back that shows all of the covered procedures and benefit information.
[CUSTOMER][NEUTRAL] right.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, for this one, I have set a specific questions. Can we go through the call?
[AGENT][NEUTRAL] Could you repeat that? I'm sorry.
[CUSTOMER][NEUTRAL] Uh, I have a set of specific questions for this one. Can you provide me on call?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Thank you. May I have the first scheduled mailing address, group name, group number?
[AGENT][NEUTRAL] Claim's mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what other information did you need? I'm sorry?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Uh, group, um, so, sir, what is the group name?
[AGENT][NEUTRAL] Group name is T as in Tango, R as in Romeo, C as in Charlie.
[AGENT][NEUTRAL] Staffing services.
[CUSTOMER][NEUTRAL] Got it. And what about for the garden and its standard nodo?
[AGENT][NEGATIVE] There is no coordination of benefits.
[CUSTOMER][NEUTRAL] All right, sir. And uh may I have the deductibles max and the used amount?
[AGENT][NEUTRAL] Sure, uh, and of course I will let you know verification of coverage is not a guarantee of payment for claims calendar year maximum is $500.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, that's for the benefit amount. The deductible is $50.
[AGENT][NEUTRAL] If you'll give me one moment, I will see what of that has been used.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Mhm. Got it. Take your time.
[AGENT][NEUTRAL] So this member has met the $50 deductible of that $500 benefit they have a remaining $128 for the calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right. And no other the coverage for this one?
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] What was that? I'm sorry?
[CUSTOMER][NEUTRAL] Sorry
[CUSTOMER][NEGATIVE] Uh, no orthodontics coverage.
[AGENT][NEUTRAL] Correct. The an orthodontic treatment is not covered.
[CUSTOMER][NEUTRAL] All right. And what about for the missing tooth loss and the waiting period?
[AGENT][NEUTRAL] There is a missing tooth cloth and there is no waiting period.
[CUSTOMER][NEUTRAL] All right. And family deductible is 150, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] All right. And can you just check for the history that might affect the frequency for preventive and diagnostic services?
[AGENT][NEUTRAL] Sure, one moment.
[CUSTOMER][NEUTRAL] and
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'm sorry, were there specific codes, uh, I was needing to look at?
[CUSTOMER][NEUTRAL] Uh, you can check for the
[CUSTOMER][NEUTRAL] All right. 012002100274 then 1206.
[CUSTOMER][NEUTRAL] And uh 11:10.
[AGENT][NEUTRAL] OK, I'm sorry that was 12:06 and 11:10?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] OK, give me just a moment. I will take a look to see if I can't find those.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] It it work I have.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 2.
[CUSTOMER][NEUTRAL] 011.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 220.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 0278.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Plus
[CUSTOMER][NEUTRAL] 135. Hello, [PII], can you hear me?
[CUSTOMER][NEUTRAL] well