AccountId: 011433970860
ContactId: e0e297e1-be9c-4daf-8f47-4a220def2caa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 578359 ms
Total Talk Time (AGENT): 98507 ms
Total Talk Time (CUSTOMER): 127903 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/e0e297e1-be9c-4daf-8f47-4a220def2caa_20250417T15:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I'm calling on behalf of the provider's office to check the dental eligibility and benefits of [PII]. Can you please help me, [PII]?
[AGENT][NEUTRAL] Uh, I can help you spell your first name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] Oh [PII], and you said that you need a claim status or eligibility and benefits, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For the eligibility and benefits.
[AGENT][NEUTRAL] Just for service in an office.
[CUSTOMER][NEUTRAL] I'm sorry, I didn't get that.
[AGENT][NEUTRAL] Where's the service office or outpatient?
[CUSTOMER][NEUTRAL] In the office, yes.
[AGENT][NEUTRAL] OK, and what's the policy number and a good phone number for you?
[CUSTOMER][NEUTRAL] The policy number is 01694082 M Mike L Lima, and number 8. And the callback number is [PII], a direct line?
[AGENT][NEUTRAL] Thank you. Give me just a second, [PII] to pull up the file, OK?
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Thanks for holding [PII], can you verify the patient's name and date of birth for me?
[CUSTOMER][NEUTRAL] Uh sure. Patient's name, [PII], and date of birth, [PII].
[AGENT][NEUTRAL] Alright, thank you. I have the information for you. I'm showing an effective date of February [PII]. Uh, this policy is active.
[AGENT][NEUTRAL] And for an office visit benefit, um, the physician's co-pay is not covered under this plan. Um, there is a treatment writer, so if covered treatment is performed in the office, those items can be considered.
[AGENT][NEUTRAL] Did you want that benefit?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or were you just looking for the physician's office visit?
[CUSTOMER][NEUTRAL] So, uh
[CUSTOMER][NEUTRAL] So, uh, [PII], this is a PPO or an HMO plan?
[AGENT][NEUTRAL] It's neither. It's a supplemental gap policy.
[CUSTOMER][NEUTRAL] Supplemental gap policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh just a moment, please.
[CUSTOMER][NEUTRAL] Just a moment, please.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh just a moment, please.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I'm not sure about that uh type of plan.
[CUSTOMER][NEUTRAL] OK, uh, so, uh, [PII], can you please bear with me for just one minute?
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much. Uh just one minute.
[CUSTOMER][POSITIVE] Um, hello [PII]. Thank you so much for bearing with me.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right. So, uh, [PII], for this patient, uh, is there any dental, uh, coverage?
[AGENT][NEUTRAL] There's no dental.
[CUSTOMER][NEUTRAL] There's no dental coverage, all right?
[AGENT][NEUTRAL] No.
[CUSTOMER][POSITIVE] Thank you so much. So, um, [PII], is it OK if you help me in checking out with just one more patient?
[AGENT][NEUTRAL] Is it under a different policy number?
[CUSTOMER][NEUTRAL] A different policy number, yes.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] And I have here it's a social number is [PII].
[AGENT][NEUTRAL] And you do not have the policy number?
[CUSTOMER][NEUTRAL] Policy number. I'm not sure whether it is the correct one or not. It's 025365557.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII], what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] And the patient's name is [PII], date of birth [PII].
[AGENT][NEUTRAL] OK, that is the policy number, the 0253655557.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Is the policy number and as far as eligibility, I'm showing that this policy was active.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the policy is no longer active as of [PII]. This is a dental policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], but it has, has been terminated, that dental policy.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] For that dental policy, it has been terminated, right? On that [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. Thank you so much. Perfect. So, uh, thank you so much for that kind information, uh, [PII]. I really appreciate your kind help. You have a good rest of your time and take care. That would be all. Thank you so much.
[AGENT][NEUTRAL] You're welcome. Anything else?
[AGENT][POSITIVE] You too, thanks for calling APO have a good day.
[CUSTOMER][NEUTRAL] You as well. Bye-bye for now.
[AGENT][NEUTRAL] Bye bye.