AccountId: 011433970860
ContactId: 8a99c274-7398-40e8-8593-62590683e16b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 256890 ms
Total Talk Time (AGENT): 111812 ms
Total Talk Time (CUSTOMER): 129880 ms
Interruptions: 4
Overall Sentiment: AGENT=0, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/8a99c274-7398-40e8-8593-62590683e16b_20250211T21:07_UTC.wav
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[AGENT][NEUTRAL] Good afternoon [PII]. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Walk out and
[CUSTOMER][NEUTRAL] Hi, um, I guess I need to get a benefit breakdown. I called earlier and wanted to fax, but I keep getting a ring and it won't come through. I don't know what's up with my fax machine, so I guess I need to do it the hard way.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, and what's the
[CUSTOMER][NEUTRAL] Unless you can email it.
[AGENT][NEUTRAL] We probably can. Uh, what's your name?
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] Oh, I talked to you earlier today. Was it for [PII]?
[CUSTOMER][NEGATIVE] Was it you? Yes, and my freaking fax machine will not go. It rang and rang, but it wouldn't come through. I got a.
[CUSTOMER][NEGATIVE] Something from a doctor earlier, but I don't know why it won't let me have it.
[AGENT][NEUTRAL] Oh bless it. Uh, what's that policy number, [PII]?
[CUSTOMER][NEUTRAL] Um, 02587044.
[CUSTOMER][NEUTRAL] Yeah, you know, if you talked about [PII] today, don't you? That's not, that's not one you forget.
[AGENT][NEUTRAL] And I've.
[AGENT][NEUTRAL] I think I had uh someone called yesterday and I, um, was it you?
[CUSTOMER][NEUTRAL] It was me and I, I thought I did today when I did it and I started saying the number I'm like, I swear I did this yesterday. I think my fax just must have been acting weird yesterday too.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] On the [PII]. Well, there was one on the [PII] I had sent it. um, Well, that's no good.
[AGENT][NEUTRAL] All right. Well, I can uh do it over the phone because his benefits are kind of limited.
[CUSTOMER][POSITIVE] Yeah we can do it that way.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] You just need a general breakdown?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK. Uh, let's see, not a guarantee of payment, just verification of coverage. He has a benefit max of up to $500 per calendar year and a $50 deductible that applies to everything but preventative.
[CUSTOMER][POSITIVE] OK thanks.
[AGENT][NEUTRAL] Preventative pays 100% of UCR, basic, basic restorative FMX panoramic pays at 80%, and under this plan, major services are not covered.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] This place is $20 today.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And is uh endo Imperio is that under major or basic? go ahead whenever you're ready.
[AGENT][NEUTRAL] Uh, major. Endoperio, oral surgery, um, those are all considered major.
[CUSTOMER][NEUTRAL] OK, so he basically just has basic coverage.
[AGENT][NEUTRAL] And preventative, yes, ma'am.
[CUSTOMER][NEUTRAL] And preventative, OK, um.
[CUSTOMER][NEUTRAL] I started to ask about missing tooth cloths, but that doesn't matter. We're not replacing anything, uh, composites covered on posterior teeth. Alright, do you cover fluoride and is there an age limit?
[AGENT][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] Uh, fluoride is, let me double check. I usually know this by heart, but give me one moment.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, [PII] is under the age of [PII].
[AGENT][NEUTRAL] And it's once every 12 months.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mm, anything else I need to know. I don't think so. I know he doesn't have any history because he was on his wife's plan and this is his own now.
[CUSTOMER][NEUTRAL] Um, let's see, on the card it says to send it to [PII]. Is that correct for dental?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK and then is there a um payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 608-01.
[CUSTOMER][POSITIVE] OK, I think that's all I need. Thank you so much. Oh, I probably should ask what about frequencies for like cleanings and is it 6 months? Is it 2 per year?
[AGENT][POSITIVE] You are welcome.
[AGENT][NEUTRAL] Uh, cleanings are once every 6 months. Uh, exams are for 12 month period.
[CUSTOMER][NEUTRAL] 6 months.
[AGENT][NEUTRAL] And like rings are once every 12 months.
[CUSTOMER][NEUTRAL] 2 and 12
[CUSTOMER][NEUTRAL] 12 months and what about for my payo?
[AGENT][NEUTRAL] Uh, once every, Lord, it's 5, I think it's 5 years. Let me double check.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Uh, once every 5 years.
[CUSTOMER][POSITIVE] OK, that's all I needed then thank you so much have a great day.
[AGENT][NEUTRAL] Uh, you too. Bye.
[CUSTOMER][NEUTRAL] Bye bye.