AccountId: 011433970860
ContactId: c678e423-3c90-4a3f-af10-fa70cfff603d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 259980 ms
Total Talk Time (AGENT): 112329 ms
Total Talk Time (CUSTOMER): 68851 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/c678e423-3c90-4a3f-af10-fa70cfff603d_20250512T12:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Hi, I'm looking to find benefits for a patient we have.
[AGENT][POSITIVE] All right. Happy to check benefits. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Sure it is 01972556.
[AGENT][NEUTRAL] All right, thank you. And then for documentation, can I grab your first name, please?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] you can be.
[AGENT][NEUTRAL] And then patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] All right. And we're looking for dental benefits or is it medical?
[CUSTOMER][NEUTRAL] Dental.
[AGENT][NEUTRAL] Dental. OK. [PII] is active. Effective date on here is [PII].
[AGENT][NEUTRAL] And then if you guys need any sort of breakdown, [PII], we can also send a fax back.
[CUSTOMER][NEUTRAL] Yeah, could you do that?
[AGENT][POSITIVE] Yeah, absolutely. uh, what is a good fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Just to confirm, I had [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Uh yes, and then I do have a couple of other questions regarding the policy.
[AGENT][POSITIVE] Yeah, no problem. Go ahead.
[CUSTOMER][NEUTRAL] Um, are we in network with this plan? Are you able to tell me?
[AGENT][NEUTRAL] Um, so this particular plan looks like there's no network, uh, required. It just pays off of a fee schedule UCR, so.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then can I have your claims address and payer ID?
[AGENT][NEUTRAL] Yeah, absolutely, so payer ID is gonna be 60801.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then the claims mailing address is going to be [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is gonna be [PII].
[CUSTOMER][NEUTRAL] And then are you able to tell me if this person is eligible for um a PanAX or a full mouth series?
[AGENT][NEUTRAL] Let me see what the history is on file here.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] And what are we looking for again? It was FMX and what else?
[CUSTOMER][NEUTRAL] And a pan
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sure they're in conjunction just if she's eligible.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Yeah, it looks like I don't see any history on file for that, so patient would be eligible.
[CUSTOMER][NEUTRAL] OK perfect and then on that breakdown you're sending over, does it have the fees on there or are you able to send me a fee schedule?
[AGENT][NEUTRAL] Yeah, so it's gonna have um all the codes and the amounts and frequencies and all of that on that absolutely and um if you don't see the code listed on there it's not covered.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Perfect
[CUSTOMER][POSITIVE] Mhm OK perfect thank you so much.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye bye