AccountId: 011433970860
ContactId: cc8e5724-ff50-4125-a026-b9a17a72f1ee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 177479 ms
Total Talk Time (AGENT): 90809 ms
Total Talk Time (CUSTOMER): 74214 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/cc8e5724-ff50-4125-a026-b9a17a72f1ee_20250318T15:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, [PII], this is [PII]. I'm calling from Doctor [PII] to verify a patient's dental coverage.
[AGENT][NEUTRAL] OK, well, I can go over the dental benefits with you and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] And the member's policy number?
[CUSTOMER][NEUTRAL] Uh, it is 00613422.
[CUSTOMER][NEUTRAL] No
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since [PII], I'm sorry, [PII]. And um did you need a copy of the fax back or you have particular questions about it?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, um, the patient also has a, uh, a Medicare, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Plan so I don't, I didn't know who to file with first. I'm sure he's had this first um but I I think when you have Medicare I think that probably is your primary and then this would be a secondary.
[AGENT][NEUTRAL] Mhm. So what
[AGENT][NEUTRAL] Yeah, well, yeah, so with our policy, there's no coordination of benefits. Um, we'll just um process as it's received. So you can, um, and Medicare comes first anyway. So we're not really second to them, but this is an additional dental policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so what I'll do, I'll file with them and then send you a copy of the EOB and then I know y'all gonna just probably pay whatever you would normally pay. Is there a fee schedule that I could get maybe get a copy of, or is that how it works?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Sure, I can send you.
[AGENT][NEUTRAL] Yes, ma'am, um, I can fax you over a copy of the fax back. So on the fax back, it, it'll have the calendar year maximum deductible and then all the frequencies, limitations, all the ways to file a claim. For this policy, it's a list of covered codes and then the amount that we would pay towards that code.
[CUSTOMER][POSITIVE] That's great.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that sounds good.
[AGENT][NEUTRAL] And what's a good fax number for you?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And should I put attention, [PII]?
[CUSTOMER][NEUTRAL] That's fine mhm.
[AGENT][NEUTRAL] OK, and it was [PII]?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][POSITIVE] Alright, so I'm gonna go ahead and send this over to you now. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] All right, [PII]. Well, thanks so much for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thanks you too then. Bye-bye. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.