AccountId: 011433970860
ContactId: d95c0999-9ad1-456c-9799-77146e14055a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 292480 ms
Total Talk Time (AGENT): 139827 ms
Total Talk Time (CUSTOMER): 107010 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/d95c0999-9ad1-456c-9799-77146e14055a_20250318T12:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I'm calling from the Proda's dental office. Could you please help me with the verification of a patient?
[AGENT][NEUTRAL] Uh, help you with?
[CUSTOMER][NEUTRAL] The benefits dental benefits of a patient.
[AGENT][NEUTRAL] Benefits. OK, I can. And would you like to schedule a benefits faxed over to you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, sure.
[AGENT][NEUTRAL] OK, and let me get the policy number first, a good callback number, and then a fax number.
[CUSTOMER][NEUTRAL] Yeah, the policy number will be 02361937.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, after that, uh, which, and you need it?
[AGENT][NEUTRAL] Either or fax number and your callback number.
[CUSTOMER][NEUTRAL] Um, uh, our fax number will be [PII].
[AGENT][NEUTRAL] And what's a good phone number in case we get dis in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, that's [PII].
[AGENT][NEUTRAL] OK, give me one moment to pull up the file.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Verify the patient's name and date of birth please.
[CUSTOMER][NEUTRAL] Yeah, that's [PII], the date of birth [PII].
[AGENT][NEUTRAL] OK, thank you for that information. So we're checking the effective date and then we'll fax the schedule benefits over to [PII].
[CUSTOMER][NEUTRAL] [PII], right.
[AGENT][POSITIVE] OK, that's what I have thank you one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I show the policy effective date of [PII].
[AGENT][NEUTRAL] Uh, this policy is active at this time. I do not show any claims history, uh, for this patient at this time. Uh, the schedule of benefits will include the calendar year maximum deductible information.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] The common limitations and exclusions.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, it will provide the percentage levels for preventive, basic, and major.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] Uh, it'll provide the claim's mailing address, payer ID number, and fax number.
[AGENT][POSITIVE] And then also it will list each procedure code that's covered by this policy and I prepared the document, you should be receiving it within the next 5 minutes. And did you have any, any other questions, [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, yeah, um, so can I, uh, uh, verify this patient through, uh, the, um, phone?
[AGENT][NEUTRAL] Portal.
[AGENT][NEUTRAL] Well, so if I verify through the phone, you don't want it faxed over to you?
[CUSTOMER][NEUTRAL] Um, yeah, um, uh, when I received the fax and I, um, filled up all the, uh, documents, I will call you back.
[AGENT][NEUTRAL] Yeah, and it's pretty detailed um so you probably won't need to it's about 9 pages to include the cover sheet, um, but of course if you need to call us back with any questions you can do that as well.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Sure, sure, sure. Um, before that, could you please confirm our provider participation?
[AGENT][NEUTRAL] If I can confirm.
[CUSTOMER][NEUTRAL] Uh, our providers participation.
[AGENT][NEUTRAL] Provider participation.
[AGENT][NEUTRAL] Yeah, there is not a network of contracted providers affiliated with this policy, so the patient can choose provider of choice.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And it's based on UCR.
[CUSTOMER][NEUTRAL] All right. Oh.
[CUSTOMER][NEUTRAL] All right. So there is no network for this um uh plan uh uh policy, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, uh, this one from the uh policyholder's name is [PII] for the date of birth [PII], is that right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, what will be the, um, like the plan name and group number?
[AGENT][NEUTRAL] And this information is also identified on the medical ID card, uh, that the patient may have. I'm showing the group number is 13611 Universal Trucking is the name of the group.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, thank you so much for that. And OK, I will call you back if there is any information I needed. Thank you so much. And could you please provide your name and reference number for this call?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference, [PII] [PII]. And any other questions, [PII]?
[CUSTOMER][NEUTRAL] Um, no, [PII]. Uh, I will, um, look at the facts and, uh, acquire the information and rest of the information. I will, uh, give you a call back.
[AGENT][POSITIVE] OK, sounds good.
[CUSTOMER][POSITIVE] Yeah, OK, thank you, [PII] for helping me out and thank you for your available time. Have a great day bye.
[AGENT][POSITIVE] You're welcome thanks for calling APL have a great day as well.
[CUSTOMER][NEUTRAL] Bye.