AccountId: 011433970860
ContactId: 782cff59-0cf2-4ccb-ab09-ffbef6021000
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 404049 ms
Total Talk Time (AGENT): 137243 ms
Total Talk Time (CUSTOMER): 141339 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/782cff59-0cf2-4ccb-ab09-ffbef6021000_20250519T13:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I'm calling from a dental office. I received an explanation of benefits that's kind of strange and so I wanted to call, um, we have a patient who I have a fax in her chart from you all showing their effective date is [PII] of this year.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the data services 51 and it says on the back of it we are awaiting information to confirm eligibility from benefits in a card upon receipt of this information, we will continue processing your claim.
[AGENT][NEUTRAL] Um, do you have the policy number for the patient?
[CUSTOMER][NEUTRAL] Sure, it is 02607688.
[AGENT][NEUTRAL] What was that patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and her date of birth is hang on just a minute here.
[CUSTOMER][NEUTRAL] Uh let me get back over to her.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] And what was that date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so what it is is benefits in a card is the third party, um, administrator that sends us the eligibility files, and they haven't come like for their to show that they're actually eligible.
[AGENT][NEUTRAL] We initially get their information and then.
[AGENT][NEUTRAL] Once the premiums were received, um, then, uh, we were able to process claims, but it looks like that's what we're waiting on is we're not, we haven't received that premium for eligibility yet. So, um.
[CUSTOMER][NEUTRAL] So is that something the patient needs to call them or I mean that's kind of crazy when we get.
[CUSTOMER][NEUTRAL] We on our end we don't know that you know that they're awaiting that when it says they're currently active.
[AGENT][NEUTRAL] Right, um, yeah, let me see here.
[AGENT][NEUTRAL] Let me, let me place you on a brief hold and um let me reach out to them real quick, OK?
[CUSTOMER][POSITIVE] OK, yeah thank you appreciate it.
[AGENT][NEUTRAL] If
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Welcome to Benefits in a card.
[CUSTOMER][NEUTRAL] For English, press one.
[CUSTOMER][NEUTRAL] Para espanol precios.
[CUSTOMER][NEUTRAL] Your call may be recorded for quality control purposes.
[CUSTOMER][NEUTRAL] Hello. Thank you for calling Benefits in the Card. My name is [PII]. Who am I speaking with?
[AGENT][NEUTRAL] Uh, my name is [PII]. I'm with American Public Life, and I was calling on for a on behalf of a mutual um member of ours, just check on eligibility.
[CUSTOMER][NEUTRAL] Sure. Um, may I have please the name of that per well, do, do you know the name of the staffing company?
[AGENT][NEUTRAL] It is
[AGENT][NEUTRAL] American Staff Corp Inc.
[CUSTOMER][NEUTRAL] OK. And can I get the last four digits of the social security number, please?
[AGENT][NEUTRAL] Uh, last four digits of the insured is [PII].
[CUSTOMER][NEUTRAL] And the name and last name?
[AGENT][NEUTRAL] Uh the first name is [PII], last name is [PII], [PII] Um and it looks like it's for a spouse, um uh [PII]
[CUSTOMER][NEUTRAL] Is there
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Honey about that.
[CUSTOMER][NEUTRAL] OK. Let me check that.
[CUSTOMER][NEUTRAL] OK. The coverage they have is uh dental and vision.
[CUSTOMER][NEUTRAL] And it's active.
[AGENT][NEUTRAL] OK, it is currently active?
[CUSTOMER][NEUTRAL] Yes, it, it's, you know, it's weekly payments and it is active until the next Sunday, [PII].
[AGENT][NEUTRAL] OK, OK, perfect. OK, I just wanted to check and we have a dental claim that we had, we were awaiting eligibility and premium notice but we haven't received that and I was gonna see if we just send it back through so.
[CUSTOMER][POSITIVE] Probably because it's too early on Monday, um, but it's showing active here with us.
[AGENT][POSITIVE] OK. OK. Well, thank you very much.
[CUSTOMER][POSITIVE] You're more than welcome. Have a wonderful day and thank you for calling Benefits in a cart.
[AGENT][NEUTRAL] Oh, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you, [PII]. Have a great day bye bye.
[CUSTOMER][POSITIVE] OK. You as well. Have a great day. Bye-bye.
[AGENT][NEUTRAL] OK, sorry about that. Um, I called Bes card and I they showed that they're active, so I'm gonna send this back through and see if we can get it processed, um, and then if there's any issues I've got your contact information, um, and then at that point the patient would need to reach out to their employer to see what's going on because these benefits are like through a temp agency, so that's, that's what the.
[CUSTOMER][POSITIVE] Oh, you're good.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We work with a third party for eligibility, etc. so, um, I'll get that sent back through though, and then, um, if we, if there's any issues like I said I've got your contact information and we'll give you a call back.
[CUSTOMER][NEUTRAL] Oh interesting, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome I appreciate your help [PII] thanks so much.
[AGENT][POSITIVE] OK, thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] You too have a good one bye bye.