AccountId: 011433970860
ContactId: 980d3874-73ca-47f7-a7e5-d32d7c07d756
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 401220 ms
Total Talk Time (AGENT): 118088 ms
Total Talk Time (CUSTOMER): 103115 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/980d3874-73ca-47f7-a7e5-d32d7c07d756_20250328T14:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Market Dental. How are you doing today?
[AGENT][POSITIVE] Doing good. How are you?
[CUSTOMER][POSITIVE] Yes, I'm doing great.
[CUSTOMER][NEUTRAL] Yes, I'm calling to verify the eligibility and benefits for the patient. Could you please help me with that?
[AGENT][NEUTRAL] You say for eligibility, is that correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK. [PII], do you have a good callback number?
[CUSTOMER][POSITIVE] Yeah thanks for calling.
[CUSTOMER][NEUTRAL] Yes the callback number is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes it's 614283.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII]. The date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And do you need benefits as well or just eligibility?
[CUSTOMER][POSITIVE] Oh, benefits as well.
[AGENT][NEUTRAL] OK, this is not a guarantee of payment, it's a basic outline of the policy.
[AGENT][POSITIVE] Uh, it looks like he is effective and active [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Uh, may I know the deductibles, individual family and the LA max?
[AGENT][NEUTRAL] And and is this for dental, is that correct?
[CUSTOMER][POSITIVE] Yes, dental. Yes, correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, just wanna make sure.
[AGENT][NEUTRAL] Um, let me pull that up.
[AGENT][NEUTRAL] Uh, give me just one moment.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, getting that pulled up.
[AGENT][NEUTRAL] Um, so it looks like I can send a fax back on this too that'll outline everything.
[AGENT][NEUTRAL] Um, but he has
[CUSTOMER][NEUTRAL] OK, can we go through this call?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Can we go through this call?
[AGENT][NEUTRAL] Sure, um, so he has a $1000 calendar year maximum.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] This is an individual policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, the
[CUSTOMER][NEUTRAL] May I know the individual?
[AGENT][NEUTRAL] The what?
[CUSTOMER][NEUTRAL] Yeah, go on. And may I know the individual and family relatable?
[AGENT][NEUTRAL] The deductible would be $50.
[AGENT][NEUTRAL] And then like I said this is individual there's no family coverage it's just individual.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then this is a fee schedule.
[CUSTOMER][NEUTRAL] There's no family covered.
[AGENT][NEUTRAL] Correct. This is a fee schedule policy.
[AGENT][NEUTRAL] So it allows a certain amount for each code. So do you want me to send you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The facts back that outlines all of that.
[CUSTOMER][NEUTRAL] Oh, can we go through this call?
[AGENT][NEUTRAL] OK, I mean, I can give you the frequencies and durations, but I mean it has several, several codes that it allows, and it's got a dollar amount for every code.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Uh, may I know the
[CUSTOMER][NEUTRAL] Yeah. May I know the coincidence of preventive basic measure?
[AGENT][NEUTRAL] So it's a it's a fee schedule based policy?
[AGENT][NEUTRAL] So it allows a certain dollar amount for each of those things. So it just depends on what code is billed, and it'll allow a certain dollar amount.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] I will tell the codes. Could you please give me the coincidence percentages?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I will give you some quotes. Could you please give me the coincidence percentages?
[AGENT][NEUTRAL] OK, yeah, do you have a code? Is that what you said?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Code is 0120.
[AGENT][NEUTRAL] $15?
[CUSTOMER][NEUTRAL] 2160.
[CUSTOMER][NEUTRAL] $15. And what is coincidence covered for this?
[AGENT][NEUTRAL] 21
[AGENT][NEUTRAL] The 2160 is $35.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 42,740?
[AGENT][NEUTRAL] 2:15.
[CUSTOMER][NEUTRAL] 215
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So there are no coincidence percentages right only.
[CUSTOMER][NEUTRAL] The dollar amount.
[AGENT][POSITIVE] Correct, it's a fee schedule policy, yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the $50
[CUSTOMER][NEUTRAL] And may I know the
[CUSTOMER][NEUTRAL] Yeah, and may I know the group name and group number?
[AGENT][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Uh, looks like this is, this is an individual policy, so there's not a group name or group number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, wait a moment, one minute.
[CUSTOMER][POSITIVE] Yeah, OK. Thank you so much for the information. That's it for my day. Bye bye.
[AGENT][POSITIVE] OK, thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Uh bye-bye.