AccountId: 011433970860
ContactId: b2f01211-497d-43ed-a6ed-26552990ec98
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275160 ms
Total Talk Time (AGENT): 84539 ms
Total Talk Time (CUSTOMER): 70838 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/b2f01211-497d-43ed-a6ed-26552990ec98_20250410T16:59_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII] calling from Jefferson Dental.
[AGENT][NEUTRAL] How can I assist you today, [PII]?
[CUSTOMER][NEUTRAL] I'm calling to verify the eligibility and benefits for your patient. Could you please help me with that?
[AGENT][NEUTRAL] Sure, I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yes, my callback number is [PII] and there is no extension.
[AGENT][NEUTRAL] And the policy number of the member that you're calling to verify benefits for today.
[CUSTOMER][NEUTRAL] As the policy number is 02013730.
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] You said your name was [PII] calling to verify benefits eligibility?
[AGENT][NEUTRAL] And this policy has been active since [PII] and it's currently active.
[CUSTOMER][NEUTRAL] What was the effective date?
[AGENT][NEUTRAL] [PII] and it's currently active.
[CUSTOMER][NEUTRAL] OK. Could you please confirm the patient name is [PII] and the date of birth is [PII]. Am I right?
[AGENT][POSITIVE] Yes, that is correct. You provided the correct information.
[CUSTOMER][NEUTRAL] OK, is patient is policy holder?
[AGENT][NEUTRAL] Yes, he is.
[CUSTOMER][NEUTRAL] OK. Ma'am, I need dental network benefits.
[AGENT][NEUTRAL] The policy does not have a network. This is the standard dental policy that covers dental services with a yearly max of $1500 per calendar year with a $50 deductible per insured up to $150 per family, that does not apply to us preventative services, and this is not a guarantee of benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh, just, just
[CUSTOMER][NEUTRAL] Ma'am, just wait a moment. These are all network benefits, right?
[AGENT][NEUTRAL] This is the policy, as I just stated, does not have a network. It's a standard dental policy that covers dental services.
[AGENT][NEUTRAL] Not a PPO nor HMO.
[CUSTOMER][NEUTRAL] So if the
[CUSTOMER][NEUTRAL] So, there is no uh participation, there is no in-network benefits, only out of network benefits.
[AGENT][NEUTRAL] That is correct. There is no network. There is a there is the policy does not have a network, so there is no network to the policy, so I can't provide you any type of information in regards to a network because the policy does not have a network. This is the open access policy.
[CUSTOMER][NEUTRAL] Uh, so the policy have only have out of network benefits, right?
[AGENT][NEUTRAL] Yes, if it has no network, then yes, ma'am, to answer your question, yes, out of network benefits because the policy does not have a network.
[CUSTOMER][NEUTRAL] Just wait a
[CUSTOMER][NEUTRAL] OK, just wait a moment, ma'am.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK. Thank you for being on hold. Ma'am, could you please provide me the facts for all the dental benefits?
[CUSTOMER][NEUTRAL] Hello, ma'am. Are you there?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello, ma'am.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello, ma'am. Are you there?
[CUSTOMER][NEUTRAL] Hello?