AccountId: 011433970860
ContactId: ac962cc0-17dc-46d1-8e46-006cb8829292
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202869 ms
Total Talk Time (AGENT): 75738 ms
Total Talk Time (CUSTOMER): 81368 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/ac962cc0-17dc-46d1-8e46-006cb8829292_20250616T14:16_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, my name is [PII]. I'm calling from a provider's office. I just wanted to get a patient's eligibility and um I've just never seen this insurance so I just wanted to know how it works.
[AGENT][POSITIVE] OK, I can help you with eligibility and benefits, [PII]. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I do. It's [PII].
[AGENT][NEUTRAL] OK, thank you. And the policy number for that patient?
[CUSTOMER][NEUTRAL] It is 02618648.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'm sure the policy is active and effective [PII].
[AGENT][NEUTRAL] Um, and this is for dental benefits, is that right?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, I can send over a fax back that shows frequency duration and outlines all the codes that are covered under the policy, um, unless there's something you need to go over.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Um, yeah, no, that'd be great. Um, can you see, are you able to see if we're in network with the insurance?
[AGENT][NEUTRAL] Um, they can go to any dentist they like.
[CUSTOMER][NEUTRAL] OK, alright, and then is this plan just like um how does the, the, the, uh, percentages like the breakdown go is it just like at 100%, 80% like.
[CUSTOMER][NEUTRAL] Or is it um
[AGENT][NEUTRAL] Um, let me.
[CUSTOMER][NEUTRAL] Like does he have to meet any out of pocket or anything before you guys start covering or?
[AGENT][NEUTRAL] Um, it's not a guarantee of payment basic outline of the policy. Let me pull it up real quick.
[CUSTOMER][NEUTRAL] It's just
[AGENT][NEUTRAL] Um, we have a $1500 calendar year maximum preventative services a 100%.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then radiographs, including FMX expenses, basic, basic restorative, I'll pay 80% after a $50 counter your deductible.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And then major major endopperio, uh, prostheontic and oral surgery, I'll pay 40%. There is a 12 month waiting period and that's $50 deductible applies.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] is
[CUSTOMER][NEUTRAL] She was really to be like.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, um, and then good that answers my question and then, um, can I just get a reference for the call and can we also get the fax back?
[AGENT][NEUTRAL] Yeah, what's your effects.
[CUSTOMER][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] OK, that was [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Uh, reference number will just be my name, [PII], first initial to last name, [PII], and today's date. And anything else I can help with today?
[CUSTOMER][POSITIVE] Um, no, that's gonna be all. Thank you so much for your help.
[AGENT][POSITIVE] OK, thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too.