AccountId: 011433970860
ContactId: debcd0a0-1d9d-4b77-b5d5-0193d2223fbd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 414440 ms
Total Talk Time (AGENT): 155616 ms
Total Talk Time (CUSTOMER): 83926 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/debcd0a0-1d9d-4b77-b5d5-0193d2223fbd_20250310T15:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning. This is [PII]. I'm trying to find out if the patient is active and if so get preventative history please.
[AGENT][NEUTRAL] OK, [PII], this is on a dental policy and you're only needing to verify the, if it's active and get the history. You already have a fax back of the benefits.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Um, well, I do if it's the same one that I got for somebody else.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Put it that way.
[AGENT][NEUTRAL] Well, it would just be dependent upon their policy. Uh there's different facts backs depending on the type of policy they have, [PII]. So, what is your, um, first off, I can help you with this, and what is your callback number?
[CUSTOMER][NEGATIVE] Gotcha.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] 746-536.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] OK, and any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name please, [PII], and their date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][NEUTRAL] And you said it was 746-536?
[CUSTOMER][NEUTRAL] 563.
[AGENT][POSITIVE] Oh, I'm so sorry. I misheard that. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And give me her date of birth one more time, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that she is a subscriber on this policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] It is taking my system one moment to load this information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] OK. So what type of information do you need for her today?
[CUSTOMER][NEUTRAL] Um, is it the same thing that she had last year with a $1000 max and $50 deductible?
[AGENT][NEUTRAL] That is correct, yes, her plan is the same if you have her faxed back then yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I just couldn't say, you know, if it was not her facts that.
[CUSTOMER][NEUTRAL] OK, right, right, um, does she have any history for preventative?
[AGENT][NEUTRAL] I can check the case. Give me just a moment. Let me get to that screen.
[AGENT][NEUTRAL] What's the first code you would like for me to check?
[CUSTOMER][NEUTRAL] Um, let's do a 0150.
[CUSTOMER][NEUTRAL] We
[AGENT][NEUTRAL] [PII] of 24.
[CUSTOMER][NEUTRAL] Um, a 0330 or 0210 POFMX.
[AGENT][NEUTRAL] There's no history for the 3:30 and you said the other code was 0210?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That one is 9-182024.
[CUSTOMER][NEUTRAL] Um, what about a 1110?
[AGENT][NEUTRAL] 91824.
[CUSTOMER][NEUTRAL] 0274.
[AGENT][NEUTRAL] No history?
[CUSTOMER][NEUTRAL] OK, um, that should be it then.
[AGENT][NEUTRAL] OK, now, uh, if you all do file a claim with us, [PII], you may already have this information, but once the claim has been processed, we do have a portal in which you all should be able to check claim status and have access to our EOB and that portal website is located at [PII].
[CUSTOMER][POSITIVE] OK got you alright.
[AGENT][NEUTRAL] All right. Well, is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Um, are we still following the Carrington fee schedule?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yes, there's been no changes on her policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Actually, in the fact that on her, on her plan has all of the benefit amounts for each code that is covered.
[CUSTOMER][NEUTRAL] Alright, that will.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is that
[CUSTOMER][POSITIVE] Perfect. OK.
[AGENT][NEUTRAL] Yes. OK.
[CUSTOMER][POSITIVE] All right thank you I appreciate your help this morning.
[AGENT][POSITIVE] Well, you are certainly very welcome. So again, if that's all I can help you with, [PII], thank you for calling APO and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] You too, thank you.
[AGENT][POSITIVE] Yes, ma'am. You're welcome. Thank you too. Bye-bye.
[CUSTOMER][NEUTRAL] Mm bye.