AccountId: 011433970860
ContactId: d696ab00-a132-4d20-94bd-bc95ca604f9e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176559 ms
Total Talk Time (AGENT): 80400 ms
Total Talk Time (CUSTOMER): 82705 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/d696ab00-a132-4d20-94bd-bc95ca604f9e_20250305T15:05_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. I'm calling to get a copy of a member's um benefits and eligibility.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] Sure, my name is [PII], and the callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Could you provide me with the spelling of your name?
[CUSTOMER][NEUTRAL] Yes, [PII]
[AGENT][NEUTRAL] Thank you and what is your fax number that you're requesting this information to be faxed over to?
[CUSTOMER][NEUTRAL] Um, that is [PII].
[AGENT][NEUTRAL] And what is the policy number of that member that you're requesting the benefits for?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. That's 02594906.
[AGENT][NEUTRAL] Can you verify that patient's name and date of birth for me, [PII]?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is, um, give me one second.
[CUSTOMER][NEUTRAL] Oh Lord. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you and you're calling to request the dental schedule to be sent over to you?
[CUSTOMER][POSITIVE] Yes, just wanted to um get eligibility and benefits for this member.
[AGENT][NEUTRAL] So you want it verbally or you want it fixed? So the member's policy has been active since [PII] and is currently active. She has a maximum benefit amount of $500 per calendar year with a $50 deductible that that does not apply to preventative services, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage. And [PII], she has not utilized any of her benefits for [PII] or me a deductible.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and you said that the max is $500?
[AGENT][NEUTRAL] Yes, $500 per calendar year and her policy only covers preventative and basic services.
[CUSTOMER][NEUTRAL] For calendar year.
[CUSTOMER][NEUTRAL] Preventative and basic only. OK. and basic. OK. And then um what is her deductible?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] $50 per $50 per insured up to $150 per family.
[CUSTOMER][NEUTRAL] $50.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and can you also send that for me, please?
[AGENT][NEUTRAL] Sure, I can send that to you by fax as well.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And anything that's not listed on the schedule means that it's not covered [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, not a problem.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, and she has no history on file?
[CUSTOMER][POSITIVE] Oh, OK, good. Um, OK, no history. All right, thank you so much. I appreciate your assistance.
[AGENT][NEUTRAL] Cause that won't be on the schedule.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL and have a great day. Thanks.
[CUSTOMER][NEUTRAL] You too bye bye.