AccountId: 011433970860
ContactId: c4678f72-0f05-4b20-8a97-5ffcf80d6a72
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 343730 ms
Total Talk Time (AGENT): 119263 ms
Total Talk Time (CUSTOMER): 79585 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/c4678f72-0f05-4b20-8a97-5ffcf80d6a72_20250116T17:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] My name is [PII]. I'm calling from provider's office, and I have a specific question for dental.
[AGENT][NEUTRAL] OK [PII], I can help you with um benefits or eligibility or is it claim status? What is it that you would like help with today?
[CUSTOMER][NEUTRAL] And the dental benefits for patients.
[AGENT][NEUTRAL] OK, Ms. [PII], um, can you please give me your callback number just in case our call gets disconnected?
[CUSTOMER][NEUTRAL] That one is [PII].
[AGENT][NEUTRAL] Thank you and what's the patient's name?
[CUSTOMER][NEUTRAL] Just showing that.
[CUSTOMER][NEUTRAL] Do you need the member ID?
[AGENT][NEUTRAL] Yes, what's the member ID?
[CUSTOMER][NEUTRAL] 02555514.
[AGENT][NEUTRAL] OK, and then what's the patient's name?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][NEUTRAL] OK, I'm gonna look up that policy real quick.
[AGENT][NEUTRAL] OK, I do have [PII] up and her effective date is [PII].
[CUSTOMER][NEUTRAL] Group number 70055.
[AGENT][NEUTRAL] The group number
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Provider is in or out? What is the fee schedule?
[AGENT][NEUTRAL] Uh, the fee schedule is based on UCR.
[CUSTOMER][NEUTRAL] OK. The annual max is 5500, and the deductible is 50.
[AGENT][NEUTRAL] And let me check for you. This is just to verify benefits, it's not a guarantee of payment. Let me pull in her fee schedule real quick so I can look at it with you.
[AGENT][NEUTRAL] Yes, you're correct. On the calendar year maximum is $500 and the calendar year deductible is $50.
[CUSTOMER][NEUTRAL] Anything has been used?
[AGENT][NEUTRAL] Let me check for you real quick.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Nothing has been used this year for [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think uh there is no waiting period, but there is a missing the clause for this policy.
[AGENT][NEUTRAL] You said there is no waiting period, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let me look on the, on the fact pack if you give me um.
[AGENT][NEUTRAL] Yes, I do not see a waiting period.
[CUSTOMER][NEUTRAL] OK. What is the co-insurance for Pravanity basic and major?
[AGENT][POSITIVE] Yes, she has um preventative expenses, 100% allowable. Basic is 80% of allowable.
[AGENT][NEUTRAL] And let me see if she has major. I don't think she has major let me look.
[CUSTOMER][NEUTRAL] I think, yeah, I don't, yes, there is no major. I know that as well.
[AGENT][NEUTRAL] No major. It's right. Are you looking at the facts back?
[AGENT][NEUTRAL] The fee schedule?
[CUSTOMER][NEUTRAL] No, only one last question. Is there any history for this patient that might defect, that's it. No more questions.
[AGENT][NEUTRAL] Let me look real quick for you.
[AGENT][NEUTRAL] No, not at this time, not as of today.
[CUSTOMER][NEUTRAL] OK. No history at all that might affect.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Tell me your name, please.
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] Reference number.
[AGENT][NEUTRAL] I'm sorry, ma'am, what did you just say?
[CUSTOMER][NEUTRAL] What is the reference number?
[AGENT][NEUTRAL] Yes, that would be my name and today's date.
[CUSTOMER][POSITIVE] Thank you so much for helping me. Have a great day. Bye.
[AGENT][POSITIVE] You're welcome, [PII]. Bye-bye, [PII]. You have a blessed day. Thanks for calling APL.
[CUSTOMER][NEUTRAL] Yeah, oh, hello?
[CUSTOMER][NEUTRAL] Hello?