AccountId: 011433970860
ContactId: c95a1b56-8773-42be-8eb6-4e5067373461
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 519000 ms
Total Talk Time (AGENT): 174430 ms
Total Talk Time (CUSTOMER): 103072 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/c95a1b56-8773-42be-8eb6-4e5067373461_20250501T18:56_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, hi, this is [PII] calling from Market in provider's office. I need to verify the patient's eligibility and benefit details. Could you assist me regarding this?
[AGENT][NEUTRAL] Well, I can assist you with the eligibility and benefits, Mr. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, I can see uh the callback number is [PII] rending extension is [PII].
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 614132.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh I can see that the patient's first name is [PII] is the first name and the middle name is [PII] and the last name is [PII], [PII]
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK, so this is for dental?
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] OK, and you say you're looking for eligibility and benefits. Do you need this information given to you verbal or faxed over to you.
[CUSTOMER][POSITIVE] We really could assist with the deductibles and annual mas participation plan.
[AGENT][NEUTRAL] OK, so you need um just a full breakdown or you have a specific questions?
[CUSTOMER][NEUTRAL] Uh, I have some specific questions. Could you go with the deductibles and annual max?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Bear with me just a minute. I'll have to pull this information. OK, one moment.
[AGENT][NEUTRAL] be.
[AGENT][NEUTRAL] OK, so this one has a calendar year max, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer calendar year maximum $1000 per cover insured with a $50 deductible if it's an individual, if it's a family it's $150 and deductible does not apply to exams or pro fees.
[CUSTOMER][NEUTRAL] Can I get the insurance percentage of preventative basic and major?
[AGENT][NEGATIVE] There is no percentages on this one. This one pays a amount per code.
[CUSTOMER][NEUTRAL] It's a co-pay policy, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, is there any group name or group number?
[AGENT][NEUTRAL] Um, yes, let me check and see if this one is part of a group.
[AGENT][NEUTRAL] This one is an individual, it doesn't belong to a group.
[CUSTOMER][NEUTRAL] Uh, could you go with an effective date for this patients plan?
[AGENT][NEUTRAL] Sure, the effective date on this one is going to be [PII], and it is active at the moment.
[CUSTOMER][NEUTRAL] Could you repeat once again?
[AGENT][NEUTRAL] That is [PII] [PII].
[CUSTOMER][NEUTRAL] Effective it is [PII].
[CUSTOMER][NEUTRAL] It's [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, is there anyest demand from the deductibles and annual max?
[AGENT][NEUTRAL] I can check on it for you, one moment.
[AGENT][NEUTRAL] As of today for [PII], he has not used her benefits, so she still have the full amount available.
[CUSTOMER][NEUTRAL] Life to maximum for the orthodontics.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Is there any history or there's no history?
[AGENT][NEUTRAL] I can check the history you asked about or and there's no order. One moment.
[AGENT][NEUTRAL] OK, so for the history, are you looking in particular just regular profi and regular um preventative or?
[AGENT][NEUTRAL] But you're looking into the.
[CUSTOMER][NEUTRAL] Is there any history for, uh, is there any history for FMX and panel?
[AGENT][NEUTRAL] FMX and panel. Let's see one moment.
[AGENT][NEUTRAL] OK, the last panel I see here was [PII].
[CUSTOMER][NEUTRAL] [PII], is there any history for uh prophylaxis Leventin?
[AGENT][NEUTRAL] The last pro I see here was [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] Your voice is breaking in or not, ma'am. I wasn't able to hear clearly [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Is there any history for bite, bite wings?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so the last flight we I got here on [PII].
[CUSTOMER][NEUTRAL] Uh, is there any history for, uh, uh, uh, sca scaling and planning.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] He was [PII].
[AGENT][NEUTRAL] Do you have a code in for that?
[CUSTOMER][NEUTRAL] There's no history, right?
[AGENT][NEUTRAL] I don't see one, but do you have a code 4341.
[CUSTOMER][NEUTRAL] 4341.
[CUSTOMER][NEUTRAL] 43, yeah.
[AGENT][NEUTRAL] Yes, one moment.
[AGENT][NEUTRAL] No, there's no history.
[CUSTOMER][NEUTRAL] 4910 periodontal maintenance.
[AGENT][NEUTRAL] You said 4910?
[CUSTOMER][NEUTRAL] Yes, right, 4910.
[AGENT][NEUTRAL] OK, the last one I got here is uh [PII].
[CUSTOMER][NEUTRAL] Is there any history for exams 01500120.
[AGENT][NEUTRAL] OK, the last order evaluation was [PII].
[CUSTOMER][NEUTRAL] Could you assist with your name and call reference number?
[AGENT][NEUTRAL] My name is [PII]. We don't have a reference numbers. You can use my name and today's date.
[CUSTOMER][POSITIVE] Thank you, thank you for providing valuable information. Have a nice day.
[AGENT][POSITIVE] You as well and thank you for calling APL bye bye.