AccountId: 011433970860
ContactId: c0b527cd-0e74-4485-b737-1a6e0b942d33
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 345579 ms
Total Talk Time (AGENT): 185914 ms
Total Talk Time (CUSTOMER): 135525 ms
Interruptions: 3
Overall Sentiment: AGENT=1.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/c0b527cd-0e74-4485-b737-1a6e0b942d33_20250127T16:21_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] you to update your information.
[CUSTOMER][NEUTRAL] Yes, I'm calling from a dental provider's office. I need to verify eligibility and get some dental benefits. May I get your name again?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] My name is
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. And may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Of course my name is [PII] The number is [PII].
[AGENT][POSITIVE] Thank you, Ms. [PII] and um sure, I can assist you with the eligibility and benefits. May I have the policy number of the patient?
[CUSTOMER][NEUTRAL] 02566774
[AGENT][NEUTRAL] All right, thank you, one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're Welcome.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Wait
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] Thank you. And um do you like this information um verbally given to you or faxed over to you, Miss [PII]?
[CUSTOMER][NEUTRAL] Please, can I get it verbally because he's coming this afternoon.
[AGENT][NEUTRAL] OK, sure, yes. And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have an effective date of [PII]. It is active at the moment and this is a dental policy. Calendar year maximum is 1500 with the $50 deductible.
[AGENT][NEUTRAL] There is a 12 month waiting period on any major service, including endoonics, periodontics, prosthodontic repair, and oral surgery.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] No, no way.
[AGENT][NEGATIVE] And deductibles does not apply to preventative.
[CUSTOMER][NEUTRAL] OK, so you said major was endodonics, periodontics, oh.
[AGENT][NEUTRAL] Uh, major includes endoonics, periodontics, prosthodontic repair, or surgery.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK, got you, um.
[CUSTOMER][NEUTRAL] Preventative is 100%?
[AGENT][NEUTRAL] Yes, preventatives cover 100%, Radiograph FMXs cover 80%, basic expense and basic restorative expenses cover 80%.
[CUSTOMER][NEUTRAL] What's major cover that?
[AGENT][NEUTRAL] 40% after the 12 month waiting period.
[CUSTOMER][NEUTRAL] OK, uh, I said I'm missing tooth cloth.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and this is a calendar year plan?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, can you give me the frequencies?
[AGENT][NEUTRAL] Sure, yes, for profies or cleanings, it's once every 6 months. Exams are 2 for 12 month period.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] By wings is once per 12-month period. Full mouth X-rays or panels are once every 5 years.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Crowns and bridges are once every 7 years per tooth, impartial and dentures is once every 5 years.
[CUSTOMER][NEUTRAL] That's Jackson
[CUSTOMER][NEUTRAL] How you doing today?
[CUSTOMER][NEUTRAL] Ok partial.
[CUSTOMER][NEUTRAL] What about scaling and new planning?
[CUSTOMER][NEUTRAL] What's the frequency?
[AGENT][NEUTRAL] What is the code on that one? That one is not listed on.
[CUSTOMER][NEUTRAL] 0 4341. You all set?
[AGENT][POSITIVE] OK, get that for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so that's going to be maximum of 1 each.
[CUSTOMER][POSITIVE] You're welcome
[CUSTOMER][NEUTRAL] Oh, you forgot the back part.
[CUSTOMER][NEUTRAL] Go ahead, I'm, I'm listening.
[AGENT][NEUTRAL] Is a maximum is for 24 months.
[CUSTOMER][NEUTRAL] OK, can all 4 cards be done on the same data service?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] OK, um, is there any fee schedule we're supposed to use or we just use the standard fee schedule?
[AGENT][NEUTRAL] Standard
[CUSTOMER][NEUTRAL] May I get
[CUSTOMER][NEUTRAL] The um
[CUSTOMER][NEUTRAL] The address for mail and claims and the payer ID please.
[AGENT][NEUTRAL] Sure. The address to send claims is [PII].
[AGENT][NEUTRAL] And the zip code, OK.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] Hold on, hold on. I'm sorry. I'm writing as fast as I can. [PII], go ahead.
[AGENT][NEUTRAL] Sure. OK.
[AGENT][NEUTRAL] Yes I'm sorry. Yeah, OK. The zip code is [PII].
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Nothing
[CUSTOMER][NEUTRAL] And you pay right there?
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][NEUTRAL] And is there any um like group name or group number?
[AGENT][POSITIVE] Oh yes, let me get that for you.
[CUSTOMER][NEUTRAL] You can send it take it with you, mhm.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so the group name is going to be Universal Trucking United Petroleum.
[AGENT][NEUTRAL] And the group number, I'm sorry, is 18528.
[CUSTOMER][NEUTRAL] And can I get a reference number to the call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][POSITIVE] No, you gave it to me already, huh? I'm good, thank you.
[AGENT][POSITIVE] Oh yeah, you're welcome and thank you for calling APO. Have a good day, Miss [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] You too thank you bye now.
[AGENT][POSITIVE] You're welcome