AccountId: 011433970860
ContactId: e5d75326-0ca1-4e93-8ba6-6c264fc4ecd6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228070 ms
Total Talk Time (AGENT): 101910 ms
Total Talk Time (CUSTOMER): 65986 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/e5d75326-0ca1-4e93-8ba6-6c264fc4ecd6_20250218T23:12_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was just calling, uh, wanted to see if my patient was still active.
[AGENT][POSITIVE] OK, I'm happy to check on eligibility and benefits for you today. Do we by chance have the member's policy number?
[CUSTOMER][NEUTRAL] Uh, yes, the ID number or the group number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, the ID number.
[CUSTOMER][NEUTRAL] OK, it is 02488562.
[AGENT][POSITIVE] All right, thank you so much. Let me pull that up here one moment.
[AGENT][NEUTRAL] And if I could get patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you. And this is for dental coverage, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, yeah, so the patient plan is still active. The effective date is [PII].
[CUSTOMER][NEUTRAL] OK, and has the patient used any benefits this year?
[AGENT][NEUTRAL] Uh, let's take a look here. One moment.
[CUSTOMER][NEUTRAL] So
[AGENT][NEGATIVE] Not showing any service dates for uh.
[AGENT][NEUTRAL] Oh, actually, I take that back. One moment.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] If you don't
[AGENT][NEUTRAL] Patient was seen it looks like on [PII].
[CUSTOMER][NEUTRAL] Like a little bit of information.
[AGENT][NEUTRAL] Um, and it looks like patient had bite wings, profo, and it looks like they had an oral exam.
[CUSTOMER][NEUTRAL] OK, um, and how much benefits remaining does she have?
[AGENT][NEUTRAL] Let me take a look here, one moment.
[CUSTOMER][POSITIVE] Um, no, I can actually give you one right now.
[AGENT][NEUTRAL] Alright, so it looks like as of today, she still has the $50 deductible and the calendar year amount of $500. Nothing has been processed at this time.
[CUSTOMER][NEUTRAL] OK, um, I do see that on our end we did submit that claim you said it just hasn't been processed yet?
[AGENT][NEUTRAL] Uh, no, it doesn't look like it. Let me see what.
[CUSTOMER][NEUTRAL] I think
[CUSTOMER][NEUTRAL] Like the old ones, yeah.
[AGENT][NEUTRAL] OK, yeah, it looks like it's still in process at this time. We're just awaiting verification from Benefits and the card who is the one that manages this through their employers, so yeah, just allow this one it looks like a little bit more time.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, no worries then, um, can I get your name and a reference number please?
[AGENT][NEUTRAL] Absolutely. Call reference is my name with my last initial and then today's date, my name is [PII], which is [PII] and my last initial is going to be [PII].
[CUSTOMER][NEUTRAL] And you said today's date?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK then I will go ahead and.
[CUSTOMER][POSITIVE] I will go ahead and let um our office know thank you so much bye.
[AGENT][POSITIVE] You're welcome. Bye bye.