AccountId: 011433970860
ContactId: dbccbc0c-29c4-4064-85de-d7533055578b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 301839 ms
Total Talk Time (AGENT): 141401 ms
Total Talk Time (CUSTOMER): 83939 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/dbccbc0c-29c4-4064-85de-d7533055578b_20250303T17:09_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, I have a new patient coming in. My name's [PII]. I'm calling from a dental office. I was hoping to get um a breakdown of dental benefits for her and her history as well.
[AGENT][NEUTRAL] OK, I can verify benefits for you, Ms. [PII], and what is the policy number, please?
[CUSTOMER][NEUTRAL] I have 7766457.
[AGENT][NEUTRAL] OK, thank you. And that's the policy number?
[CUSTOMER][NEUTRAL] That is the only ID number that the patient has provided us.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] Yeah, it's not coming up. What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII] is the policyholder [PII], and his date of birth is [PII].
[AGENT][NEUTRAL] 48. And you said the first name is [PII]?
[CUSTOMER][NEUTRAL] [PII], yeah.
[AGENT][NEUTRAL] Uh let me see.
[AGENT][NEUTRAL] Uh, let's see, so [PII].
[AGENT][NEUTRAL] OK, I can give you the policy number when you're ready. It looks like.
[AGENT][NEUTRAL] There's too many numbers in that policy number you gave.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it's 766-457.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK, and Ms. [PII], do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, and it's for Mr. [PII]. OK, and you say you're calling to verify eligibility benefits and history?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I show his effective date is [PII]. He is active on the policy.
[AGENT][NEUTRAL] And are you just need a general breakdown or I can't send you a fax back?
[CUSTOMER][NEUTRAL] Um, if you can send me, well, let me ask you, I have one in here and I don't know if this plan belongs to them, um.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] Oh shit, this plan.
[CUSTOMER][NEUTRAL] There's no in or out of network, right? They, you guys pay on a dollar amount instead of percentages.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Correct. We pay according to that policy fee schedule. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, then it looks like somebody already did this so um for his wife [PII] she's actually the one coming in. Can you just tell me if she's used anything yet this year and what she if she's eligible for um like an FMX an exam?
[AGENT][NEUTRAL] OK, uh, Ms. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, let's see
[AGENT][NEUTRAL] See
[AGENT][NEUTRAL] Um, looks like her last exam was [PII] of this year, so she's not eligible for an exam.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Looks like she is eligible for bike wings and a regular cleaning. It looks like she had um per maintenance on [PII]. I'm sorry. Let me see.
[AGENT][NEUTRAL] Uh, it looks like she had a pair of maintenance on the [PII], and those are once every 3 months, I believe, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But she is eligible and as far as benefits she use for this year, give me a moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And it looks like she has used $100 of her benefit max of $1000.
[AGENT][NEUTRAL] And she has $2 left for her deductible.
[CUSTOMER][NEUTRAL] OK, and then can you tell me the date of her last FMX or pano?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] I don't show history of an FMX or Pao, so she is eligible.
[CUSTOMER][POSITIVE] OK, sounds good. Then that's really all, oh yeah, that's it that's all I need so thank you very much.
[AGENT][NEUTRAL] Oh, well, first, oh, you say you already have the fax back, correct?
[CUSTOMER][NEUTRAL] Yeah it looks like somebody did already do it um yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well,
[CUSTOMER][POSITIVE] OK, good deal.
[AGENT][POSITIVE] All right, Ms. [PII]. You are welcome and I thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] That's it then thank you very much.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.