AccountId: 011433970860
ContactId: d9c6b239-3209-4343-958b-12b758741991
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 868710 ms
Total Talk Time (AGENT): 178747 ms
Total Talk Time (CUSTOMER): 230824 ms
Interruptions: 3
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/d9c6b239-3209-4343-958b-12b758741991_20250129T18:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello there. This is sir and I'm looking for dental benefits for my patient.
[AGENT][POSITIVE] OK, I can help you with benefits for your patients. Can you give me the facility name you're calling from?
[CUSTOMER][NEUTRAL] the pan.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, sir, that will be then the lounge.
[AGENT][NEUTRAL] OK, and what is the patient's name?
[CUSTOMER][NEUTRAL] Patient's name, uh, patient's name you ask?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, that will be [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, we're talking about.
[AGENT][NEUTRAL] OK, and then what is your callback number, sir, just in case our call gets disconnected?
[CUSTOMER][NEUTRAL] OK, that will be [PII] with no extension direct line.
[AGENT][POSITIVE] Thank you. And you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, [PII]
[CUSTOMER][NEUTRAL] A
[AGENT][NEUTRAL] OK, thank you [PII], and then what is the patient's policy number?
[CUSTOMER][NEUTRAL] 455.
[CUSTOMER][NEUTRAL] 426
[CUSTOMER][NEUTRAL] That will be.
[CUSTOMER][NEUTRAL] 08 01822695.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] 058.
[CUSTOMER][NEUTRAL] 210
[AGENT][NEUTRAL] And then what is the patient's date of birth?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] date of birth will be [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, looking at the policy I do see that [PII] does have an active policy. His effective date is [PII].
[AGENT][POSITIVE] And if you give me your fax number I'll send you the complete benefit breakdown for this insured.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Actually, I do have the breakdown. I just want to know if there is any used amount from the annual maximum or the any use, any new procedures that the patient have done for this year.
[AGENT][NEUTRAL] No, sir, he has not filed anything for the year of [PII].
[CUSTOMER][NEUTRAL] I just want to confirm the group name is Universal Tech Stevens Transport, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEGATIVE] Uh, and this policy have no orthodontic coverage also.
[AGENT][NEUTRAL] The policy has no what?
[CUSTOMER][NEUTRAL] 79532.
[CUSTOMER][NEUTRAL] Oh, so only the coverage.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And uh any change in missing tooth cloths or waiting period?
[AGENT][NEUTRAL] No, no changes.
[CUSTOMER][NEUTRAL] Uh, like, no waiting period and, uh, there is a missing too clothes, right?
[AGENT][NEUTRAL] That's all the same.
[CUSTOMER][NEUTRAL] OK, ma'am, can you just provide me the history for this one from previous year or any history?
[AGENT][NEUTRAL] History for previous year.
[AGENT][NEUTRAL] What specifically are you looking for?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I'm looking for any history for crowns, dens, or white wings, example CSRP.
[CUSTOMER][NEUTRAL] And the course do you down down some.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look it's gonna be just a moment. I'm gonna put you on hold while I search.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII], can you give me the procedure codes for the services you're looking for?
[CUSTOMER][NEUTRAL] and
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Sure, uh.
[CUSTOMER][NEUTRAL] 012001400180 then 1110, then 0274 then 021003304341.
[CUSTOMER][NEUTRAL] 275-027402950 and 2332, that's it.
[AGENT][NEUTRAL] OK, I'm gonna put you on hold again. I'm gonna search those for you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, thank you for holding for me, [PII].
[AGENT][NEUTRAL] OK. I did find uh that the insured had.
[CUSTOMER][NEUTRAL] If
[AGENT][NEUTRAL] 1110 done on [PII] and [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] He had procedure 2332 done on [PII].
[CUSTOMER][NEUTRAL] And ma'am, uh,
[AGENT][NEUTRAL] He had procedure.
[CUSTOMER][NEUTRAL] Just want to make sure
[CUSTOMER][NEUTRAL] Yes, uh, the code 2332, any two number for that code?
[AGENT][NEUTRAL] No, I didn't see a tooth number and then on uh 29.
[CUSTOMER][NEUTRAL] Uh, ma'am, uh, can you just double check, uh, there should be a number for that code. That's why I'm asking.
[AGENT][NEUTRAL] OK, let me put you on hold real quick.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you, [PII]. I did find the tooth number on 2332 on [PII], he had tooth number 9 and 8 done.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you for that.
[AGENT][NEUTRAL] You're welcome. And then on procedure 2950.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That was also done on [PII].
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Street number
[AGENT][NEUTRAL] Uh, let me look for you.
[CUSTOMER][NEUTRAL] Ma'am, uh, this is [PII], right?
[AGENT][NEUTRAL] 24.
[CUSTOMER][NEUTRAL] 24. OK. For this one, it is 24 and 423, 32 it's on [PII].
[AGENT][NEUTRAL] Right, 2332 was [PII]. I'm sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The procedure 2950 was done on [PII].
[CUSTOMER][NEUTRAL] Um, OK. 2 number?
[AGENT][NEUTRAL] Tooth number was.
[AGENT][NEUTRAL] Number 3 and number 14.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Any other history besides this?
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Then on procedure number 2740.
[AGENT][NEUTRAL] That was also done on [PII].
[CUSTOMER][NEUTRAL] OK. To number for that one?
[AGENT][NEUTRAL] Uh, choose number 31, 14, and 3.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then that's all.
[CUSTOMER][NEUTRAL] And ma'am, uh, is the provider in or out of network for this one?
[AGENT][NEUTRAL] No, we're, they're in network.
[CUSTOMER][NEUTRAL] In network and uh which the schedule shall we use then?
[AGENT][NEUTRAL] UCR.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh the coverage percentage for diagnostic 100 and basic 80 and uh
[CUSTOMER][NEUTRAL] major services 40, right?
[AGENT][NEUTRAL] Right, that's on the fax back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh ma'am, can you just spell your name for me?
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] And the reference number for this call?
[AGENT][NEUTRAL] Yes, you can use my name and today's date.
[CUSTOMER][POSITIVE] OK. Thank you. Have a good day and bye for now.
[AGENT][POSITIVE] You're welcome. Thank you.