AccountId: 011433970860
ContactId: b8cc2dc3-e7d2-471b-a36b-4a64fd972513
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219979 ms
Total Talk Time (AGENT): 107619 ms
Total Talk Time (CUSTOMER): 95587 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/b8cc2dc3-e7d2-471b-a36b-4a64fd972513_20250122T14:19_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from a dental office in [PII], and I'm calling to um get uh to verify that this person is covered through you for dental insurance and to get.
[CUSTOMER][NEUTRAL] The uh benefits breakdown.
[AGENT][NEUTRAL] OK, would you like to get the benefits passed over to you?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what's the spell your first name and if you could provide the policy number?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEGATIVE] Uh, the first, my first name or his first name, you're cutting in and out.
[AGENT][NEUTRAL] Your your name.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII], OK, and the policy number?
[CUSTOMER][NEUTRAL] 791,080.
[AGENT][NEUTRAL] Your phone number in case we're disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and what's your fax number?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK how long ago?
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], last name is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] The date of birth?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] His date of birth is [PII].
[AGENT][NEUTRAL] Thank you. I'm showing the policy effective date is [PII] currently active. Um, the schedule of benefits will include the calendar year max, uh, information, deductible information, um, the common limitations exclusions. Um, it'll list each procedure code that's covered under the patient's policy. Um, our claims mailing address, payer ID number, and fax number is also included on the schedule.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, as well as the frequencies, and you should have it within the next 5 to 7 minutes and
[CUSTOMER][NEUTRAL] How about the history?
[AGENT][NEUTRAL] Uh-huh, I can check that for you. Is it just for preventive?
[CUSTOMER][NEUTRAL] Yes, well, actually, no, he is coming in for a filling.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] For what too and what code?
[CUSTOMER][NEUTRAL] 20
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And I think that's 2391.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And so of course, that would be considered um.
[AGENT][NEUTRAL] A basic service and you said it's 2331?
[CUSTOMER][NEUTRAL] 91.
[AGENT][NEUTRAL] 2391 and as you see on the schedule, the code will be listed and it'll give you the dollar amount per code.
[AGENT][NEUTRAL] Um, 2391. That code is actually not covered under this policy.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, mhm.
[AGENT][NEGATIVE] Mhm. It's not covered.
[CUSTOMER][NEUTRAL] How about [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh, resin one service that pays out at at.
[AGENT][NEUTRAL] $65.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right.
[AGENT][POSITIVE] Alrighty, and you should receive this within the next 5 to 7 minutes.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, [PII]. Anything else I can help out with today?
[CUSTOMER][POSITIVE] That's all thank you.
[AGENT][POSITIVE] Uh, you're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Um bye bye.