AccountId: 011433970860
ContactId: b32da63c-6388-4335-acfe-2674c720afd3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 413829 ms
Total Talk Time (AGENT): 165528 ms
Total Talk Time (CUSTOMER): 132760 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/b32da63c-6388-4335-acfe-2674c720afd3_20250130T13:31_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, ma'am. Good morning, Ms. [PII]. Um, my name is [PII]. I'm calling from a provider's office and I have a mutual patient that I need to do a dental breakdown on.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, you need it, I'm sorry, there's a little bit of an echo [PII] on our call. Did you say that you were needing a breakdown of dental benefits?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh yes, ma'am.
[AGENT][POSITIVE] Yes, I can help you with that, [PII]. And what is your callback number?
[CUSTOMER][NEUTRAL] Uh, callback number is [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Um, policy number is 01691413.
[AGENT][NEUTRAL] Thank you. One moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name, please, and their date of birth?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that he is a subscriber on this dental plan and it is active with an effective date of [PII].
[AGENT][NEUTRAL] And give me just a moment to get his fax that pulled up.
[AGENT][NEUTRAL] And [PII], will the facts need to be put to your attention?
[CUSTOMER][NEUTRAL] Uh yes, that'd be fine.
[AGENT][NEUTRAL] It does need to be put to your attention? OK.
[CUSTOMER][NEUTRAL] Um, you don't have to, no, ma'am, but if you want, if you would like to, you can, but you don't have to.
[AGENT][NEUTRAL] OK, well that's fine.
[AGENT][NEUTRAL] And what is a good fax number for you, please?
[CUSTOMER][NEUTRAL] Uh yes ma'am, fax number is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, again that was excuse me.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][POSITIVE] And that fact will literally have like everything group name group number all the above.
[AGENT][NEUTRAL] I can give you the group number and group name that is not on there. The group number for him is 13003.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One second, let me get, I'm sorry, 1, you said 13003?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the group name is Universal Trucking.
[AGENT][NEUTRAL] Wall Street.
[AGENT][NEUTRAL] Systems.
[CUSTOMER][NEUTRAL] And wall like wall, W A L L.
[AGENT][POSITIVE] Correct. Yes, ma'am. Uh-huh.
[CUSTOMER][NEUTRAL] Got you and system with S or no S?
[AGENT][NEUTRAL] Yes, it does have an S.
[AGENT][NEUTRAL] The Universal Trucking Wall Street Systems.
[CUSTOMER][NEUTRAL] All right, OK.
[CUSTOMER][POSITIVE] All right, perfect.
[AGENT][NEGATIVE] And then anything not on the fax back means it would not be covered under the plan.
[CUSTOMER][NEUTRAL] And just to make sure when we say universal that is it ending in SAL.
[AGENT][NEUTRAL] I'm sorry, your voice cut out at the beginning. Say that again, universal like.
[CUSTOMER][NEUTRAL] So, um,
[AGENT][NEUTRAL] Like Universal Studios in [PII].
[CUSTOMER][POSITIVE] OK, perfect, yes.
[AGENT][NEUTRAL] And then [PII], once we have processed the claim, we do have a portal in which you should be able to check claim status and have access to our EOB and our portal website for that is secured.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Alright, yes ma'am, and um the only other thing I would like to verify is if it's in or out of network or if that's even something that matters.
[AGENT][NEUTRAL] No, ma'am, this is not a network plan they may choose any provider.
[AGENT][NEUTRAL] Covered services are based on a percentage of the UCR of the service region, and it does state that as well on the fax back.
[CUSTOMER][POSITIVE] Got you so
[CUSTOMER][NEUTRAL] Got you so it would never be a we wouldn't, we wouldn't be in network regardless.
[AGENT][NEUTRAL] No, ma'am, because there's not, no, this policy is not affiliated with any network.
[CUSTOMER][NEUTRAL] OK, yes ma'am.
[AGENT][NEUTRAL] And do you have any other questions for me today?
[CUSTOMER][NEUTRAL] Um, I believe that will be all. Do you typically know about how long that 5-10 minutes for the fax?
[AGENT][POSITIVE] It's been sent, so provided that your fax line is open, yes, you should be receiving that very soon.
[CUSTOMER][POSITIVE] Alright perfect yes ma'am well I believe that is all I needed then thank you so much.
[AGENT][POSITIVE] Well, you are certainly very welcome, [PII], and thank you again for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you you too, ma'am.
[AGENT][POSITIVE] Yes, ma'am. Thank you so much.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Bye.