AccountId: 011433970860
ContactId: b3bcf03f-7209-46c7-a5e1-50fd5be46404
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249919 ms
Total Talk Time (AGENT): 85367 ms
Total Talk Time (CUSTOMER): 108242 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/b3bcf03f-7209-46c7-a5e1-50fd5be46404_20250117T13:33_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] My name is [PII]. Um, I actually have a few questions about a patient, I believe.
[AGENT][NEUTRAL] OK, and the policy number?
[CUSTOMER][NEUTRAL] Um, I have a 60801.
[AGENT][NEUTRAL] That's the payer ID number. Do you have the card?
[CUSTOMER][NEUTRAL] I don't.
[AGENT][NEUTRAL] Spell the patient's first and last name?
[CUSTOMER][NEUTRAL] Um, OK, I think he, I think he doesn't speak English, so it kind of, I think the policy holder, um, forgive me if I'm wrong, is OK. Last name is [PII].
[CUSTOMER][POSITIVE] Perfect um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Date of birth is gonna be [PII].
[AGENT][NEUTRAL] Are you a dental provider?
[CUSTOMER][NEUTRAL] I am.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] Just want to make a copy show my paper.
[AGENT][NEUTRAL] And what's the date of birth?
[CUSTOMER][NEUTRAL] Um, I have [PII].
[AGENT][POSITIVE] Alright, thanks for verifying that information for me and what questions did you have?
[CUSTOMER][NEUTRAL] OK, um, that's not my patient. That's, I think that's a subscriber. My patient is gonna be UA [PII].
[CUSTOMER][NEUTRAL] M A [PII]
[CUSTOMER][NEUTRAL] Last name is the same.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Date of birth.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK and what questions do you have?
[CUSTOMER][NEUTRAL] Um, is this a PPO policy?
[AGENT][NEUTRAL] There's, there's no network affiliated with this, this particular dental policy. They can go to any provider of their choice.
[CUSTOMER][NEUTRAL] OK, can I have the member ID number?
[AGENT][NEUTRAL] It's 233.
[AGENT][NEUTRAL] 5618.
[CUSTOMER][NEUTRAL] OK and then can I have the group name and group number?
[AGENT][NEUTRAL] The group number is 13611.
[AGENT][NEUTRAL] And Universal Trucking is the name of the group.
[CUSTOMER][NEUTRAL] some
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Oh yes thank you I
[CUSTOMER][NEUTRAL] OK, and then can I have the effective date in the PO box that I filed to?
[AGENT][NEUTRAL] 505123 is the effective date. Policy is active. The claims mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 8950.
[CUSTOMER][NEUTRAL] You said 7324?
[AGENT][NEUTRAL] 73 1 24.
[CUSTOMER][NEUTRAL] Sorry, and then can is it a calendar plan?
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] And is there a waiting period or missing two calls on this one?
[AGENT][NEUTRAL] There is a missing tooth cloth. There's a 12-month waiting period for major services, and I can fax the schedule for to you if you'd like.
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] That number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, it's gonna have all of the benefit information on there to include the exclusions, common limitations, um, each procedure code that's covered under the policy.
[AGENT][NEUTRAL] As well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um did I get the subscriber right like she is it's not reversed correct?
[AGENT][NEUTRAL] She's a dependent on the policy.
[CUSTOMER][NEUTRAL] OK, just making sure.
[CUSTOMER][NEUTRAL] And then does she have any history that affects frequency?
[AGENT][NEUTRAL] There's no history on file, no claims on file?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, I take that. Give me one second.
[CUSTOMER][NEUTRAL] And that 12 months is
[CUSTOMER][NEUTRAL] Go ahead, you're fine.
[AGENT][NEUTRAL] Yeah, no claims have been paid under this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So she's OK for an FMX and a panel.
[AGENT][POSITIVE] And no claims have been paid on the policy, so yes.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Uh-huh. Anything else?