AccountId: 011433970860
ContactId: a56fc17a-c313-4530-9abc-3016a37af3bb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 372109 ms
Total Talk Time (AGENT): 123630 ms
Total Talk Time (CUSTOMER): 88435 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/a56fc17a-c313-4530-9abc-3016a37af3bb_20250408T15:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII], and I'm calling to verify our patient's dental benefits.
[AGENT][POSITIVE] OK, Miss [PII], I can help you with benefits. May I get your call back number?
[CUSTOMER][NEUTRAL] Uh, sure. It's [PII].
[AGENT][NEUTRAL] OK, thank you very much. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Patient's name is [PII], and the date of birth is [PII]. And the policy number is 2051968.
[AGENT][NEUTRAL] OK, let me look that up.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy with us. The effective date of the policy is [PII], and if you can give me your fax number, I'll send you a fax back with the benefit breakdown and fee schedule.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Uh, our fax is [PII].
[AGENT][NEUTRAL] OK, Miss [PII], I'm gonna put you on a brief hold while I get that fax ready for you and I will be right back.
[CUSTOMER][POSITIVE] Thank you so much, [PII].
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] UTBA.
[AGENT][NEGATIVE] Pork.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, Ms. [PII]. I have that fax on its way to you now.
[CUSTOMER][POSITIVE] Thank you so much. Um, uh, can I also ask a few questions about the plan?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK. Uh, do you accept assignment of benefits?
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] So if the facility turns in the claim, then the facility is paid. If the patient turns in the claim, then the patient is paid.
[CUSTOMER][NEUTRAL] OK. So, uh, you can pay by the provider and you can also pay directly to the patient, correct?
[AGENT][NEUTRAL] Right, it depends on on the claim if you mark the box to send the uh assignment of benefits to the patient, then we'll send it to the patient, but if you do not mark the box on your claim form for the assignment, then it goes to the provider.
[CUSTOMER][POSITIVE] OK, got it. No worries. Um, how about the, uh, missing tooth loss or any waiting period?
[AGENT][NEUTRAL] There is, uh, and all that is on your fax back that you're getting. It'll have all that information, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me pull it up real quick again.
[AGENT][NEUTRAL] And see
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] It does have a missing tooth cloth.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] And same with the waiting period as well.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is just to verify benefits. It's not a guarantee of payment, uh.
[AGENT][NEUTRAL] The waiting period is only for, and it's 12 months for major expense endedonic expenses, periodontic expenses, prosodontic repair expenses, and oral surgery.
[AGENT][NEUTRAL] That's the only waiting period.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][POSITIVE] OK. I think I'll be waiting for the fax box. Thank you so much for your help.
[AGENT][POSITIVE] OK. Well, you're very welcome. Is there anything else I can help you with Isla, before we go?
[CUSTOMER][POSITIVE] That will be all. Thank you so much, [PII].
[AGENT][POSITIVE] You're welcome. You have a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] You too. Thanks. Bye.
[AGENT][NEUTRAL] Bye-bye.