AccountId: 011433970860
ContactId: d4047955-3cbd-46b3-bcf7-f6f168a97c86
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 368760 ms
Total Talk Time (AGENT): 121611 ms
Total Talk Time (CUSTOMER): 111731 ms
Interruptions: 0
Overall Sentiment: AGENT=2.5, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/d4047955-3cbd-46b3-bcf7-f6f168a97c86_20250331T16:37_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII]. I'm calling from Hilton Dental. How are you doing?
[AGENT][POSITIVE] I'm doing well, Ms. [PII]. How are you doing today?
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][POSITIVE] Good, thank you for asking.
[AGENT][NEUTRAL] Um, Ms. [PII], can I please get your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][POSITIVE] OK. And how can I help you today?
[CUSTOMER][NEUTRAL] Well, I'm calling to verify patients eligibility and benefit and also I need to check if my provider they're in or out of network.
[AGENT][NEUTRAL] OK, I can help you with eligibility benefits and network. What is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] [PII] and ID num the member ID number is 02545282.
[CUSTOMER][NEUTRAL] And date of birth, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I know.
[AGENT][POSITIVE] Thank you so much. I appreciate you verifying that for me.
[AGENT][NEUTRAL] Alright, I do show that [PII] does have an active policy with us and his effective date is [PII].
[AGENT][NEUTRAL] And if you can
[CUSTOMER][NEUTRAL] Any waiting periods or any.
[AGENT][POSITIVE] Right, if you can give me no no that's OK if you can give me your fax number I'll send you a benefit breakdown and fee schedule that will have all that information on there for you.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][POSITIVE] Awesome, it's 248.
[CUSTOMER][NEUTRAL] 744
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 2652.
[AGENT][NEUTRAL] OK, it's gonna be a quick hold, Miss [PII] while I get that fax ready for you and I will be right back and let you know when it's finished.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] All right. Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Come on.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you, Miss [PII] for holding for me. I have that fax on its way to you now.
[CUSTOMER][NEUTRAL] Sure, OK, and that there is any way that you can check for me if my provider they're in or out of network?
[AGENT][NEUTRAL] Uh, they can use any network that they, they want to use.
[CUSTOMER][NEUTRAL] Oh, OK, so like there is no out of network and in network um benefit it's just like you guys, you pay to uh to our UCR, uh, fee?
[AGENT][POSITIVE] Yes, yes, that's correct.
[CUSTOMER][NEUTRAL] OK. And can you tell me if there is any missing tooth cloths on the planet or any waiting periods?
[AGENT][NEUTRAL] Uh yes ma'am, there is a missing two clause, and let me pull that fax up that I just sent you it'll tell about the waiting periods. Hold on real quick. Let me pull it up and this is just to verify benefits. It's not a guarantee of payment. Um, there are no way.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Great
[CUSTOMER][NEUTRAL] OK, what about if there is any alternate benefit on the plan for fillings, crowns, or bridges?
[AGENT][NEUTRAL] Um, what do you mean alternate?
[CUSTOMER][NEUTRAL] So like you know for the white composite filling do you guys downgrade to a mogum or for the white porcelain crown, do you guys downgrade? OK, so there is no downgrade.
[AGENT][NEUTRAL] No, we don't.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And what about implant? Is it a cover benefit?
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][NEGATIVE] Yes, um, your voice is cutting off.
[AGENT][NEUTRAL] Can you hear me? Oh, good. Yes. OK, thank you. Oh, I mean.
[CUSTOMER][NEUTRAL] Yes, I can hear you now.
[CUSTOMER][NEUTRAL] So all that is gonna be on the fax?
[AGENT][NEUTRAL] Yes, ma'am. Everything will be on the fax and if you're looking for a procedure code that is not on the fax, then it's not covered.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK, so if the procedure code if it's not on the tax is not a covered benefit. OK, perfect. Thank you so much for your help, and let me make sure of the payer ID number, um, is that the 60801?
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, ma'am. That's right.
[CUSTOMER][POSITIVE] OK perfect thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] No, that'll be all, thanks.
[AGENT][POSITIVE] Thank you you have a wonderful day and thank you for calling APL.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye, Miss [PII].