AccountId: 011433970860
ContactId: b2163797-c7b8-4069-9f70-b41f7739183d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 279190 ms
Total Talk Time (AGENT): 104838 ms
Total Talk Time (CUSTOMER): 85102 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/b2163797-c7b8-4069-9f70-b41f7739183d_20250123T15:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, good morning, [PII]. My name is [PII] calling on behalf of our dental office to check benefits. Please help me with that.
[AGENT][NEUTRAL] May I please have a call back number and then the policy number?
[CUSTOMER][NEUTRAL] Callback number [PII].
[CUSTOMER][NEUTRAL] And the member ID 0258.
[CUSTOMER][NEUTRAL] 2785
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth, [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy. You're calling in for benefits for this member. Would you like a fax back?
[CUSTOMER][NEUTRAL] Uh, if it's verbally, you can just provide me verbally, please.
[AGENT][NEUTRAL] OK, you said
[AGENT][NEUTRAL] Do it verbally.
[CUSTOMER][NEUTRAL] Uh, yes, if possible, do it verbally actually.
[AGENT][NEUTRAL] OK, what benefits are you needing for me to review?
[CUSTOMER][NEUTRAL] Uh, dental benefits can let me know first the group number and group name for the policy.
[AGENT][NEUTRAL] So you're needing for benefits, you're needing the group number and group name?
[CUSTOMER][NEUTRAL] Yes, can you start with that? I have other questions as well. This is my first question.
[AGENT][NEUTRAL] The group number is 70056.
[AGENT][NEUTRAL] And the group name is Management analysis and Utilization.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And what is the effective date?
[AGENT][NEUTRAL] The effective date is showing [PII].
[CUSTOMER][NEUTRAL] [PII], OK. And what are the maximum and deductible amount?
[AGENT][NEUTRAL] For this member, verification of coverage does not guarantee the payment of the claim. For the calendar year max, they have up to $500 per covered insured, and for the calendar year deductible they have up to $50 per covered insured.
[CUSTOMER][NEUTRAL] Anything has been used.
[AGENT][NEUTRAL] Let me check that for you.
[CUSTOMER][NEUTRAL] Format
[AGENT][NEGATIVE] As of right now, the member has not used any of their benefits.
[CUSTOMER][NEUTRAL] OK, got it. And waiting period apply on this policy or no?
[AGENT][NEUTRAL] For this policy is showing that there is no waiting periods.
[CUSTOMER][NEUTRAL] OK. And do we have orthodontics coverage on the policy?
[AGENT][NEUTRAL] Could you repeat that please?
[CUSTOMER][NEUTRAL] Orthodontics benefits are covered on this plan for dental?
[AGENT][NEUTRAL] Let me check that for you. Orthodontics is not covered.
[CUSTOMER][NEUTRAL] Not bad. OK. And does the patient have any dental history on file?
[AGENT][NEUTRAL] I'm not seeing that the member has any dental history with us.
[CUSTOMER][POSITIVE] OK, no issue on file at all for the patient, eligible for all services. OK.
[CUSTOMER][NEUTRAL] And uh what is the claim's mailing address?
[AGENT][NEUTRAL] The mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. And can you help me with your name, spelling, and the reference for our call, please?
[AGENT][NEUTRAL] The reference will be my first name spelled [PII]
[AGENT][NEUTRAL] [PII] KIA last initial of [PII] and today's date. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, this will be all. Thank you for your assistance and I hope you have a wonderful rest of your day and take care.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great rest of your day as well.