AccountId: 011433970860
ContactId: bd629cb0-873b-4d75-9a60-0ae82f694d6c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 699799 ms
Total Talk Time (AGENT): 225924 ms
Total Talk Time (CUSTOMER): 200236 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/bd629cb0-873b-4d75-9a60-0ae82f694d6c_20250516T15:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is. How may I help you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. I'm calling from a dental provider's office trying to verify eligibility and benefits for a patient.
[AGENT][NEUTRAL] OK Miss [PII], I can help you with both eligibility and benefits. Uh, can I please get your call back number and the name of the provider's office you're calling from?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, it is um [PII] and um it is Key Dental Group.
[AGENT][POSITIVE] OK thank you miss
[AGENT][NEUTRAL] [PII], and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, um, [PII], his date of birth is [PII], and he gave us 02346809.
[AGENT][NEUTRAL] OK, let me look him up real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It be just a moment while I pull him in.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] Right, may I have um.
[AGENT][NEUTRAL] Your fax number so I can send the benefits.
[CUSTOMER][NEUTRAL] My what? I'm sorry?
[AGENT][NEUTRAL] Your fax number so I can send the benefits.
[CUSTOMER][NEUTRAL] OK, yes, [PII].
[AGENT][NEUTRAL] Thank you and I do show that uh Xavion does have an active policy. The effective date of his policy is [PII].
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] And it's a brief hold while I get those benefits together to fax back to you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] And I'll be right back.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 8123.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you Ms. [PII] for holding for me. I've got that fax on its way to you now, ma'am.
[CUSTOMER][NEUTRAL] OK perfect um does that I um I don't have any information about any of these plans. Does he, um, like the claims mailing address, payer ID?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And there's a group number.
[AGENT][NEUTRAL] Yeah, that is your fax back.
[CUSTOMER][NEGATIVE] It'll be on the fax back. OK, great. Is this a oh, OK, I'm sorry, this is kind of a bad connection. It keeps breaking up. OK.
[AGENT][NEUTRAL] I can give you the first number.
[AGENT][NEUTRAL] Oh, I apologize. OK, group number is 1205.
[CUSTOMER][NEUTRAL] OK,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's
[AGENT][NEUTRAL] P as in Paul and S as in Sam.
[CUSTOMER][POSITIVE] Oh goodness.
[CUSTOMER][NEUTRAL] Can you hear me OK?
[AGENT][POSITIVE] Yes, and I can adjust mine.
[CUSTOMER][NEUTRAL] Can you hear me OK?
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, Ms. [PII], hopefully you can hear me better now.
[CUSTOMER][NEUTRAL] Oh OK, OK, alright, so um I've got the group number 19205.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the current name is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, alright, and what is the um the payer ID?
[AGENT][NEUTRAL] It is 60801.
[CUSTOMER][NEUTRAL] OK perfect OK and then the client's mailing address?
[AGENT][NEUTRAL] That is [PII].
[CUSTOMER][NEUTRAL] Uh huh
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Oh, I'm so sorry.
[CUSTOMER][POSITIVE] OK, could you repeat that? I'm so sorry.
[AGENT][NEUTRAL] It's OK, it's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], Oklahoma.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect. OK, um, does this plan have any, um, like a missing tooth claws?
[AGENT][POSITIVE] Yes, ma'am, it does.
[CUSTOMER][NEUTRAL] It does OK and any waiting periods? I mean, I know he's 8123, but.
[AGENT][NEUTRAL] Yes ma'am, and this is just his benefits. It's not a guarantee of payment. He has uh a 12 month waiting period for major endodontic, periodontic, prosthodontic, and oral surgery.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK perfect OK and then uh I guess one more thing, does he have any history on file?
[AGENT][NEUTRAL] Let me check.
[AGENT][NEUTRAL] Any claims.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so looking at he's had one claim that was sent in for data service of [PII].
[AGENT][NEUTRAL] And I'll give you the procedure codes.
[CUSTOMER][NEUTRAL] What was that again? I'm so sorry. It just it just keeps breaking up. OK, what was that of 25?
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] 55 of 2025.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, got that. OK.
[AGENT][NEUTRAL] And I can give you the procedure code that he used that day.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] He used 00330.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 01110.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 00150.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And 00274.
[CUSTOMER][NEUTRAL] OK, perfect. OK um and let's see, so has he used um any what have, what has he used of his annual max?
[AGENT][NEUTRAL] Let me check that for you real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] OK, he still has his $1500 maximum left.
[AGENT][NEUTRAL] And he still has his deductible left to pay of $50.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] As of today.
[CUSTOMER][NEUTRAL] OK, OK, so that that he had done on [PII] didn't come out of this 1500?
[AGENT][NEUTRAL] Let me see if it was paid.
[CUSTOMER][NEUTRAL] Maybe it probably hadn't been paid yet mhm yeah.
[AGENT][NEUTRAL] Um,
[AGENT][POSITIVE] Give me just a minute while I pull in the claim to see if anything was paid. Yes ma'am, they, they did, they're in the process of paying it, so we got them at a good time. Um, the claim is being paid $24.
[CUSTOMER][NEUTRAL] OK, sure, yeah, uh huh.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] 200, what do I'm sorry, 254?
[AGENT][NEUTRAL] 94.
[CUSTOMER][NEUTRAL] 294. OK, perfect. Did he meet his deductible on that?
[AGENT][NEGATIVE] It's not showing me that he met his deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, perfect, um, OK, and then everything else should be on the fax back.
[AGENT][NEGATIVE] Yes ma'am and if you're looking for a procedure that's not on there then it's not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Uh huh
[CUSTOMER][NEUTRAL] OK perfect and then one last thing that just might not be his benefit renewal is it a calendar year?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] OK perfect OK thank you so much for your help I appreciate it.
[AGENT][POSITIVE] You're very welcome, Miss [PII]. Is that everything I can help you with before we go?
[CUSTOMER][POSITIVE] That is it, thank you so much.
[AGENT][POSITIVE] You have a wonderful weekend. Thank you for calling APL.
[CUSTOMER][POSITIVE] Thanks. You too. Bye-bye.