AccountId: 011433970860
ContactId: adf44953-0903-4575-80df-885261c9cb9b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 640630 ms
Total Talk Time (AGENT): 161678 ms
Total Talk Time (CUSTOMER): 120025 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.1, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/adf44953-0903-4575-80df-885261c9cb9b_20250509T19:53_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check dental benefits.
[AGENT][POSITIVE] OK, I can help you with eligibility and benefits. Can I please get your first name again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, Ms [PII], and then what is um your callback number just in case our call is disconnected?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, [PII], no extension.
[AGENT][NEUTRAL] OK, and may I please have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Doctor [PII] DDS and Doctor [PII], DDS LLC.
[AGENT][NEUTRAL] Oh, thank you. And then may I please get the um member's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Member's name is
[CUSTOMER][NEUTRAL] [PII] [PII]. Date of birth is [PII]. And you need policy number as well, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] 02116844.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, I do show that Malicia 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. One moment.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. In the meantime, can you please check the provider's participation?
[AGENT][NEUTRAL] Can I check what for the patient, ma'am?
[CUSTOMER][NEUTRAL] For the provider's participation if provider is in or of metric.
[AGENT][NEUTRAL] they can use anybody they want to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the fax number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I get that fax ready for you and I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Molly stop
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you, bunny for holding for me. I have that faxed on its way to you now, ma'am.
[CUSTOMER][NEUTRAL] Um, OK. And, uh, is there anything used on it from the maximum deductible, and can you please provide me the history?
[AGENT][NEUTRAL] OK, let me check on the maximum and the deductible.
[AGENT][NEUTRAL] They still have their deductible left to pay and they still have their maximum benefit for the calendar year.
[CUSTOMER][NEUTRAL] OK, nothing new, nothing that.
[AGENT][NEGATIVE] Nothing. Right.
[CUSTOMER][NEUTRAL] OK. And uh
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And the history for the patient for preventive basics and major?
[AGENT][NEUTRAL] OK, and what is the code?
[CUSTOMER][NEUTRAL] 0120.
[AGENT][NEUTRAL] OK, let me look this up.
[AGENT][NEUTRAL] The last time that was used was on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 0274.
[AGENT][NEUTRAL] [PII] and what was the next one? I'm sorry.
[CUSTOMER][NEUTRAL] 0274.
[AGENT][NEUTRAL] OK, let me look that one.
[AGENT][NEUTRAL] That was also done on [PII].
[CUSTOMER][NEUTRAL] And 1110.
[AGENT][NEUTRAL] That was also done on the same day, [PII].
[CUSTOMER][NEUTRAL] OK. 0210.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't show that's been used.
[CUSTOMER][NEUTRAL] And 0330.
[AGENT][NEUTRAL] And I don't show that one's been used either.
[CUSTOMER][NEUTRAL] OK. Uh,
[CUSTOMER][NEUTRAL] 1208
[AGENT][NEUTRAL] That has not been used either.
[CUSTOMER][NEUTRAL] Uh, coming to the basics in major 4341.
[AGENT][NEUTRAL] No history on that one.
[CUSTOMER][NEUTRAL] OK. Uh 4910.
[AGENT][NEUTRAL] No history on that one.
[CUSTOMER][NEUTRAL] OK. And uh
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] 2740
[AGENT][NEUTRAL] That one was last used on [PII].
[CUSTOMER][NEUTRAL] 2740, April [PII] of 34, Street number?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Shot number, please?
[AGENT][NEUTRAL] Is that every
[AGENT][NEUTRAL] I'm sorry, tooth number, I'm sorry, 19.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 19. Any coverage for, I mean, any history for 2950?
[AGENT][NEUTRAL] Yes, that was done on [PII], also tooth number 19.
[CUSTOMER][NEUTRAL] OK. Uh 6740.
[AGENT][NEGATIVE] That has no history.
[CUSTOMER][NEUTRAL] OK. And uh 2393?
[AGENT][NEGATIVE] That has no history also.
[CUSTOMER][NEUTRAL] OK, and.
[CUSTOMER][NEUTRAL] OK. Your claim mailing address and pay ID?
[AGENT][NEUTRAL] Payer ID is 60801. The claim's mailing address is [PII]. That's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] And that will also be on your fax back.
[CUSTOMER][NEUTRAL] Your name and reference number?
[AGENT][NEUTRAL] Um, my name is [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can use my name and today's date as the reference.
[CUSTOMER][POSITIVE] Thank you. Have a great day.
[AGENT][POSITIVE] You too, buddy. You have a nice day also and thanks for calling APL.