AccountId: 011433970860
ContactId: aff949ab-9fea-4c0f-bfb2-d7974117acdd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 531760 ms
Total Talk Time (AGENT): 156057 ms
Total Talk Time (CUSTOMER): 123019 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/aff949ab-9fea-4c0f-bfb2-d7974117acdd_20250306T23:50_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII] calling on behalf of dental office to check on eligibility and verification for a patient on a recorded call. Can you please help me with that?
[AGENT][NEUTRAL] Yes, ma'am, and you said your name was [PII]?
[CUSTOMER][POSITIVE] Yes, that's right.
[AGENT][NEUTRAL] OK, Ms. [PII]. And what is the name of the dental facility you're calling from?
[CUSTOMER][NEUTRAL] Mhm. Sure. Uh.
[CUSTOMER][NEUTRAL] Facility name I have is Arrowhead Dental Group and Orthodontics.
[AGENT][NEUTRAL] OK, thank you Ms. [PII] and then what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Mm OK.
[CUSTOMER][NEUTRAL] Callback number I have is [PII]. It's a direct line?
[AGENT][POSITIVE] Thank you and you need to get eligibility and benefits.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Uh, what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Patient's name I have is [PII]. And date of birth is [PII].
[AGENT][NEUTRAL] OK, and then what's Ernest's policy number, please?
[CUSTOMER][NEUTRAL] Um, sure. Policy number I have is 02255429.
[AGENT][POSITIVE] OK, thank you so much. Let me look that policy up real quick.
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I do show that Ernest does have an active policy and his effective date is [PII].
[AGENT][NEUTRAL] And if you give me your fax number I can send you a fax back with the complete benefit breakdown and fee schedule.
[CUSTOMER][NEUTRAL] OK, got that. So all the information I'll be getting from the fax, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] The history as well.
[AGENT][NEUTRAL] Uh, I can check history for you here real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what are the procedure codes that you need me to check on for you?
[CUSTOMER][NEUTRAL] Um, the history I need to check is for 0120.
[CUSTOMER][NEUTRAL] 0210.
[AGENT][NEUTRAL] OK, let me check that.
[CUSTOMER][NEUTRAL] 0274.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You said that was 01210 was the first one.
[CUSTOMER][NEUTRAL] Uh no, it's 01.
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Yes, yeah, 0120.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The last time that um that code was used was.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then 0.
[AGENT][NEUTRAL] 274.
[AGENT][NEUTRAL] That code was used, um, and he has a history of that one on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Are those the two?
[CUSTOMER][NEUTRAL] 0210.
[AGENT][NEUTRAL] OK, that's that was also done on [PII].
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] Then [PII].
[AGENT][NEUTRAL] I don't see that he's used that benefit yet.
[CUSTOMER][NEUTRAL] OK. Then 4341.
[AGENT][NEUTRAL] Uh, I do not see that that procedure has been used.
[CUSTOMER][NEUTRAL] OK. Then the last code of 4910.
[AGENT][NEUTRAL] And I do not see that one.
[CUSTOMER][NEUTRAL] OK, got that. Thank you so much, [PII]. Then, uh, I just want to confirm for annual max, will I get from fax as well, annual max and the used amount?
[AGENT][POSITIVE] Yes, you will.
[AGENT][NEUTRAL] Yes, ma'am, um, what is your fax number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, sure. The fax number I have is [PII].
[AGENT][NEUTRAL] OK and then let me look real quick.
[AGENT][NEUTRAL] I do show that um and this is just to verify his benefits. It's not a guarantee of payment. He does have to pay his $50 deductible and he has his benefit of $1500 left for this year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 1500 left. OK.
[CUSTOMER][NEUTRAL] Got them.
[AGENT][NEUTRAL] OK, is there anything else I can help you with? I'm gonna put you on a quick hold while I send that fax over to you.
[AGENT][NEUTRAL] For his benefits and his fee schedule?
[CUSTOMER][NEUTRAL] Um, I know.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, it's gonna be a.
[CUSTOMER][NEUTRAL] I'm sure you can provide me the fax, yeah.
[AGENT][POSITIVE] Yes, ma'am. Thank you. It's gonna be a brief hold while I get that sent to you. I'll be right back.
[CUSTOMER][NEUTRAL] Oh. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me Miss [PII]. I have that flat fax on its way to you now.
[CUSTOMER][POSITIVE] OK, sure. Then that's all will be for now, [PII]. Thank you so much for the information you provided and have a good day. Bye-bye for now.
[AGENT][POSITIVE] Bye bye Ms. [PII]. You have a good night. Thanks for calling APL.
[CUSTOMER][POSITIVE] Thank