AccountId: 011433970860
ContactId: c0fd04eb-14b1-47b6-a22b-f673123341f5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 126150 ms
Total Talk Time (AGENT): 67760 ms
Total Talk Time (CUSTOMER): 41103 ms
Interruptions: 0
Overall Sentiment: AGENT=2.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/c0fd04eb-14b1-47b6-a22b-f673123341f5_20250130T19:10_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, I'm calling from a dental provider's office uh to get some eligibility and benefit information.
[AGENT][POSITIVE] Sure. Can I have your name and a callback number and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm it's [PII] [PII].
[AGENT][NEUTRAL] [PII], what is the policy number of the member that you're inquiring eligibility for?
[CUSTOMER][NEUTRAL] 02565039
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], this policy has been active since [PII] and is currently active. This policy has a maximum benefit amount of $500 per calendar year with a $50 deductible per insured up to $150 per family, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Are there percentages or is it a fee schedule or what are the covered?
[AGENT][NEUTRAL] Preventative is covered at 100 and basic is covered at 80. Unfortunately, major endoperoprosthesis or surgery, crowns, bridges, ortho perioendo, none of that is covered under the policy and I can send you a fax back if you would like.
[CUSTOMER][POSITIVE] Oh, that'll be great. um, the fax number is [PII].
[AGENT][NEUTRAL] I have [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] This member has no history on file?
[AGENT][NEUTRAL] Or have they utilized any of their benefits for 25 or met their deductible?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any procedure code that's not listed means that it's not covered under the policy, [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][POSITIVE] Understood. OK, thank you very much.
[AGENT][POSITIVE] You're welcome. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] Thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thanks. Bye bye.