AccountId: 011433970860
ContactId: dbe96213-5f36-41de-8dcb-e88c6c0a3f74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 282140 ms
Total Talk Time (AGENT): 113567 ms
Total Talk Time (CUSTOMER): 98827 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/dbe96213-5f36-41de-8dcb-e88c6c0a3f74_20250418T14:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, um, I had received a fax for some benefits that I had requested just a couple of minutes ago and I just had some questions.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I can help you with the benefit questions. May I please get your name and your callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My name is [PII] and the callback number is [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Lincoln Community Health Center.
[CUSTOMER][NEUTRAL] Do you
[AGENT][NEUTRAL] OK, thank you. And then may I get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, the patient's name is [PII].
[CUSTOMER][NEUTRAL] The um date of birth is, let's see, [PII].
[CUSTOMER][NEUTRAL] Number is 606175.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, let me pull up the fact that you're looking at.
[AGENT][NEUTRAL] So that I can see the same thing you've got pulled up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. I've got it pulled up now. And what were your questions you had about the facts back?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I see that there's benefit amounts for each service.
[CUSTOMER][NEUTRAL] Um, and I saw that there is an annual max. Does the patient, like usually it shows what percentage the patient is covered at for each service. How does, how does y'all dental plans work like.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so this particular dental plan, the amount that you see, the benefit amount is all that will be paid.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, so whatever our fee is for the service we would just subtract the benefits.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] We have for the service and then the patient pays the remainder of the amount.
[AGENT][NEUTRAL] Correct. Um, and that, that's how it works. It's just that's the total benefit amount for that covered procedure. And if there's a procedure that needs to be done that's not on the fax back, then it's a non-covered procedure.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so if uh if this patient just comes in for a cleaning X-ray and exams, then I'm just confused as to know how much the patient is supposed to pay.
[AGENT][NEGATIVE] We don't give patient responsibility because there's so many times that the provider will do discounts and things like that so we never give the patient responsibility, um.
[AGENT][NEUTRAL] For the preventative, for the cleanings, you would just go by the procedure code and the amount that the benefit amount.
[AGENT][NEUTRAL] And then determine from that what you would want to charge the patient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I got you. OK, that's all I needed to know.
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] OK, all right. Well, it, there's no other questions you have for me about the benefits?
[CUSTOMER][NEUTRAL] No ma'am, that's it. I was just trying to figure out how it works.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, ma'am, I understand. OK. All right, well I hope you have a blessed Easter and we thank you for calling APL.
[CUSTOMER][POSITIVE] But I got you.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you, Ms. [PII]. Mhm. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.