AccountId: 011433970860
ContactId: b3744cb3-dc2f-4aa2-87bb-e4cc1a19f6b1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 383899 ms
Total Talk Time (AGENT): 127342 ms
Total Talk Time (CUSTOMER): 161249 ms
Interruptions: 4
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/b3744cb3-dc2f-4aa2-87bb-e4cc1a19f6b1_20250225T20:17_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling to verify dental benefits and eligibility. How are you doing today?
[AGENT][POSITIVE] I'm doing fine. How are you, [PII]? Do you have a phone number I can get in case we get disconnected I can call you back.
[CUSTOMER][POSITIVE] I'm doing fine how are you today? Yeah.
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] Do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is uh
[CUSTOMER][NEUTRAL] 2, sorry, 02579702.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] What's the patient's name?
[CUSTOMER][NEUTRAL] Patient's first name is [PII].
[CUSTOMER][NEUTRAL] And the last name is [PII] and the date of birth is on [PII].
[AGENT][NEUTRAL] Thank you [PII], and you were needing claim status?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Or eligibility.
[CUSTOMER][NEUTRAL] Uh sorry?
[AGENT][NEUTRAL] You are needing claim status eligibility.
[CUSTOMER][NEUTRAL] Eligibility.
[AGENT][POSITIVE] OK, I can help you with that.
[AGENT][NEUTRAL] You want it over the phone or would you like a fax back?
[CUSTOMER][NEUTRAL] Uh, before that, I would like to confirm some of the information, then I'll go with either fax back or a verbal breakdown. So first of all, I would like to check the patient [PII] is also a subscriber of the policy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] He is and what's your fax number?
[CUSTOMER][NEUTRAL] Uh, one moment.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] May I have the deductibles and the annual maximum of the plan?
[AGENT][NEUTRAL] Any benefits given over the phones, not a guarantee of payment. The maximum is 1500 per calendar year.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You.
[AGENT][NEUTRAL] $50 deductible per calendar year except for um preventative.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] That's the
[CUSTOMER][NEUTRAL] OK. May I have the preventative basic and measure coinsurance percentages?
[AGENT][NEUTRAL] It is 18,040.
[CUSTOMER][NEUTRAL] OK, 1 2nd.
[AGENT][NEUTRAL] Of the usual.
[CUSTOMER][NEUTRAL] Is it under the group of, uh-huh.
[AGENT][NEUTRAL] Of the usual and customary rate.
[CUSTOMER][NEUTRAL] OK, may I have the group name and the group number of this?
[AGENT][NEUTRAL] 16068.
[CUSTOMER][NEUTRAL] 16068.
[AGENT][NEUTRAL] And as you know,
[AGENT][NEUTRAL] Universal trucking.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And I'll spell the last word, it's H I R S C H B A C H.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] So universal trucking, right?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Harsh but.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, so the fax that will have all the details like the missing tooth cloth, uh, waiting periods, downgrades, and also the history with the used amounts.
[AGENT][NEUTRAL] The history will not be on there. I can give you that. Uh, hold on one moment.
[CUSTOMER][NEUTRAL] Some me on there
[CUSTOMER][NEUTRAL] So, if there is any issue on the file, can you please help me with the history?
[AGENT][NEUTRAL] Yes, I said, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] I'm faxing you the benefits real quick.
[AGENT][NEUTRAL] OK, he has no history, he has not met the deductible and he has not used any of the maximum.
[CUSTOMER][NEUTRAL] Does the patient policy have the coverage for orthodontics?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, to any waiting periods?
[AGENT][NEUTRAL] Let's see, his effective date was [PII], so it would, he would have a 12-month wait on major work.
[CUSTOMER][NEUTRAL] 12 months wait on major, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Missing tooth cloth?
[AGENT][NEGATIVE] There is a missing too cloth.
[CUSTOMER][NEGATIVE] Downgrades for fillings, please.
[AGENT][NEGATIVE] We do not downgrade.
[CUSTOMER][NEUTRAL] not
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] So, will it have the, uh, all the procedure codes and along with the frequencies?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And I just want to make sure, is it universal tracking or universal tracking?
[AGENT][NEUTRAL] Trucking T R U C K I N G.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, one moment. I got a policy here.
[CUSTOMER][NEUTRAL] Just give me 1 2nd.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] American Public Life.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I got everything completed here. OK. How much time will it take, uh, will it take for the fax back?
[AGENT][NEUTRAL] I'm not sure. I already faxed it, so you should be getting it.
[CUSTOMER][POSITIVE] Thank you so much. May I have your name spell out for me?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII] It looks like we already gave [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] Benefits today on this policy.
[CUSTOMER][NEUTRAL] OK. You have all of the benefits. OK, OK, no problem. May I have the reference number for the call conversation, please?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name and today's date.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. Thank you so much. Have a wonderful evening. Take care. Bye.
[AGENT][POSITIVE] Thank you, [PII] for calling APLU as well. Bye-bye.