AccountId: 011433970860
ContactId: a236c06c-8173-46a1-af6e-f454b9b91b4c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 292420 ms
Total Talk Time (AGENT): 110793 ms
Total Talk Time (CUSTOMER): 146892 ms
Interruptions: 3
Overall Sentiment: AGENT=1.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/a236c06c-8173-46a1-af6e-f454b9b91b4c_20250129T20:59_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]. How are you today?
[AGENT][NEUTRAL] I am good and may I, I'm sorry, may I have your name again please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], thank you and your callback number, [PII]?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] It is without extension [PII].
[AGENT][NEUTRAL] Thank you. And may I have the policy number, please?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 021-94838.
[AGENT][POSITIVE] Thank you. One moment please.
[AGENT][NEUTRAL] Verify the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] [PII] date of birth is [PII].
[AGENT][NEUTRAL] OK, I have that number pulled up. And how may I assist you with the patient, please?
[CUSTOMER][NEUTRAL] They yeah.
[CUSTOMER][NEUTRAL] So I have just specific questions only and what is the max remaining for this patient and yearly max.
[AGENT][NEUTRAL] Please note the verification of benefits provided by that guaranteed payment. The max is $1500 and the member has $1500 remaining.
[CUSTOMER][NEUTRAL] OK, and has deductible been met?
[AGENT][NEUTRAL] No, I have not been met.
[CUSTOMER][NEUTRAL] OK, for that. And is there any history for, uh, sorry, the second question is, does exam share frequency all exam share frequency, got that. And is there any history for example that may affect the frequency?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I know
[AGENT][NEUTRAL] Remember I had an exam on the limited oral exam on [PII].
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]. Yes, one moment, still checking for you.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Maybe
[CUSTOMER][NEUTRAL] Wait.
[AGENT][NEUTRAL] The member is eligible for an exam.
[CUSTOMER][NEUTRAL] on
[CUSTOMER][NEUTRAL] OK, and does this patient have any preventative history that will affect the frequency?
[AGENT][NEUTRAL] OK, on.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] On [PII] member also had FMX. That's one per five year period shares with the pan.
[CUSTOMER][NEUTRAL] OK, go there.
[AGENT][NEUTRAL] And prior to [PII], the member had on [PII], the prophy, that's once every six months.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Uh, it was on trophy was on.
[AGENT][NEUTRAL] December, [PII].
[CUSTOMER][NEUTRAL] So it will not affect the frequency.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] And as far as bite wings, the last bite wings were also done on [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And that's one for 12
[CUSTOMER][NEUTRAL] OK, they will not affect the but.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, I just need which may I you can see they are FMX and pan or got that and just a moment let me re-verify everything before we continue.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, is there any waiting period for basics and veg services?
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] Alright, thank you for
[AGENT][NEUTRAL] Yes the member has satisfied the 12 month waiting period for major services, and that was for the effective date of [PII].
[CUSTOMER][NEUTRAL] So you should get that here in the next 10 to 15 minutes.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, so it is not eligible now, so, OK, got that.
[AGENT][NEUTRAL] I'm sorry, the member does not have a waiting period as of now. He has met the waiting period.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Oh sorry sorry pronunciation OK and uh you said your name was [PII].
[AGENT][NEUTRAL] Yes, my name is [PII]. My last initial is [PII].
[CUSTOMER][NEUTRAL] um
[CUSTOMER][NEUTRAL] OK, and what will be the reference number? No, that will be all, [PII]. What is the reference number for this call?
[AGENT][NEUTRAL] And [PII], anything else I can assist you?
[AGENT][POSITIVE] Thank you. That would be my name and today's date.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK, uh, I want to re-verify that 1500 is remaining correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] OK, got it. That will be all. Thank you so much for the information. Have a great day bye bye.
[AGENT][POSITIVE] Thank you for calling Atel. Have a great day. Bye-bye.