AccountId: 011433970860
ContactId: a547b481-6941-4ee3-8623-1d7002f1b0d1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 592080 ms
Total Talk Time (AGENT): 204015 ms
Total Talk Time (CUSTOMER): 221479 ms
Interruptions: 7
Overall Sentiment: AGENT=0, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/a547b481-6941-4ee3-8623-1d7002f1b0d1_20250106T15:47_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from a provider office. I wanted to get a little bit more information regarding a patient's plan.
[AGENT][NEUTRAL] OK, [PII], you're needing benefit information for a member, is that correct?
[CUSTOMER][NEUTRAL] Yes, I have the ID number as 022.
[CUSTOMER][NEUTRAL] 18787.
[CUSTOMER][NEUTRAL] I'm sorry, it's [PII].
[AGENT][NEUTRAL] Thank you. And what is your callback number, [PII]?
[AGENT][NEUTRAL] What is your callback number?
[CUSTOMER][NEUTRAL] Look at.
[AGENT][NEUTRAL] OK, thank you. So give me a moment to get the member's information pulled up please.
[CUSTOMER][NEUTRAL] I that I don't know. It depends how much is there. It depends on it did, OK, yeah, so yeah, I don't more than likely he could possibly do it today. Uh, he'd be kind of work into the schedule, so it'll be.
[AGENT][NEUTRAL] And any information that I provide for you today, sir, will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, uh, yeah, let me, let me.
[CUSTOMER][NEUTRAL] The patient is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, and this is on a dental policy, is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, have you received the 5 sack of benefits for this member, [PII]?
[CUSTOMER][NEGATIVE] Um, no, we requested that the patient's actually in the office right now. We haven't received anything.
[CUSTOMER][NEUTRAL] We requested it earlier today.
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] OK, so give me just a moment.
[CUSTOMER][NEUTRAL] So I'm calling back to see if I can give it over the phone or if I can try to get it back faster.
[AGENT][NEUTRAL] Yeah, I can sure send it. I'll be happy to pull that up and send that to you. I'm not sure.
[CUSTOMER][POSITIVE] And a good phone number.
[AGENT][NEUTRAL] Why you haven't received it, but give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] First time you don't call yourself.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you know who you spoke with earlier today?
[CUSTOMER][NEUTRAL] Um, I didn't have it written down, but they said they gave it a while for it to come through.
[CUSTOMER][NEUTRAL] Which to the code number
[CUSTOMER][NEUTRAL] Where's your teeth that hurt?
[CUSTOMER][NEUTRAL] Lower
[AGENT][NEUTRAL] What is your fax number, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Does it need to be put to your attention or is that not necessary?
[CUSTOMER][NEUTRAL] No, it's not necessary.
[AGENT][NEUTRAL] OK, and again that fax number is [PII]. Is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I have, I have just sent that to you, so it's, it's on its way. I have sent it.
[AGENT][NEUTRAL] Um, in the meantime, is there
[AGENT][NEUTRAL] Something I can answer for you, and again, any information provided would be a verification of benefits and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Um, yeah.
[CUSTOMER][NEUTRAL] OK, um, and for that, uh, breakdown, is it code specific or is it just like 8040 does it just.
[CUSTOMER][NEUTRAL] Is it
[AGENT][NEUTRAL] Yes, it's a percentage. Yes, it's based on a percentage of the UCR.
[CUSTOMER][NEUTRAL] That way I can just ask those questions.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so is.
[AGENT][NEUTRAL] The covered services are based on a percentage of the UCR.
[CUSTOMER][NEUTRAL] Got it. OK, um, and for his plan, is there, is it cold specific or is it pretty much any cold is covered?
[AGENT][NEGATIVE] No, if there are any codes that this fact back consists, and the total fact back is 8 pages.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So yes, it has specific codes.
[AGENT][NEUTRAL] That are covered.
[CUSTOMER][NEUTRAL] OK, and for me, for me to get that fax back, what is the time frame that I should wait because the patient's actually here in the chair now.
[AGENT][NEUTRAL] Um, it's, yes, it's actually, I mean, I have sent it, so I'm not sure why.
[AGENT][NEUTRAL] Why they said that it would take a little while, just as long as it takes to, I mean, for it to be sent. Again, I have faxed it, so you should be receiving it provided that the fax line is open. Does this come to your a computer or a machine?
[CUSTOMER][NEUTRAL] Alright this is.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It should be just a few minutes.
[CUSTOMER][POSITIVE] Um, it's, it's connected to the computer, yeah, it doesn't, it's a pretty, it's we, it's pretty fast, we get faxes.
[AGENT][NEUTRAL] I mean,
[AGENT][NEUTRAL] Yeah, this, um.
[CUSTOMER][NEUTRAL] It is what is your pharmacy that you need?
[AGENT][NEUTRAL] I mean, I would say normally just a few minutes. Uh.
[CUSTOMER][NEUTRAL] With pharmacy
[CUSTOMER][NEUTRAL] What's the phone number to them?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And
[AGENT][NEGATIVE] I didn't even send it to you again. So you should get it 2 times within the next, I mean, just as, as long as it takes to come through. Now, you may have to refresh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] To see it depending on how your system works, Lord, today, every system is so different.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But I have actually sent it to you twice.
[CUSTOMER][NEUTRAL] OK, let's see if it has come through.
[CUSTOMER][NEUTRAL] Is there also a way to email it too, or is it only by?
[AGENT][NEUTRAL] Yeah, I can, but it's gonna take me just a moment to be able to do that for you. Just one second.
[CUSTOMER][NEUTRAL] It doesn't you sure sometimes they'll call.
[CUSTOMER][NEUTRAL] OK, I'm here just because he's here. I just wanna make sure I get it entered and not have to call back again.
[AGENT][NEUTRAL] Sure, yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Do we have the
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] What is your social
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And go ahead and give me the email that you would like this sent to.
[CUSTOMER][NEUTRAL] If you can send it to [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct, mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, uh, is everything
[CUSTOMER][NEUTRAL] Driver's license so I can put your your address and everything.
[AGENT][NEUTRAL] And [PII], do you spell your name with an [PII] or no [PII]?
[CUSTOMER][NEUTRAL] With an H.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I I I look at it.
[CUSTOMER][NEUTRAL] OK, in case of an emergency, do you want us to contact your son or who?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, what's his name?
[CUSTOMER][NEUTRAL] Do you know his phone number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so I have just sent that to you via email. So give that just a moment and see if you received that.
[CUSTOMER][POSITIVE] Oh cool
[CUSTOMER][POSITIVE] OK, thank you so much and have a good day.
[AGENT][NEUTRAL] Well, you're welcome. Do you want to verify, you want to wait just a minute to make sure that you do get it?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, let's see.
[CUSTOMER][POSITIVE] I got it thank you so much, yep.
[AGENT][NEUTRAL] Oh perfect. OK, well, is there anything else, and I don't know if the lady you spoke to earlier or not gave you our portal website, [PII], but once the claim has been processed with APL, we do have a portal in which you can check claim status by going to [PII].
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Got you alrighty thank you so much and have a good day.
[AGENT][POSITIVE] OK, yes ma'am well you too and thank you again for calling APL. I hope you have a great day as well.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye-bye.