AccountId: 011433970860
ContactId: eac1bd87-c9ce-4dec-b420-0afc7a55d245
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 670400 ms
Total Talk Time (AGENT): 227284 ms
Total Talk Time (CUSTOMER): 317461 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/eac1bd87-c9ce-4dec-b420-0afc7a55d245_20250224T21:44_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, my name is [PII]. I am calling from a dental provider's office, um, and I was just calling. I have a patient that has a service with you guys, um, and I'm trying to kind of log on online but it keeps saying that there's an error and to give you guys a call so um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I keep saying no user was found with the info given, so I just wanted to give you guys a call and see if y'all can help me verify eligibility.
[AGENT][NEUTRAL] It would be my pleasure to verify eligibility and it may be that we don't have a claim on file from you um for eligibility that is not available online, but
[AGENT][NEUTRAL] You can check claim status and have access to our ELBs once a claim has been processed.
[CUSTOMER][NEUTRAL] Oh OK I got you yeah I don't.
[AGENT][NEUTRAL] So that may be the issue.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][POSITIVE] But I'll be happy to help you with eligibility.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] And what is a good callback number, [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII] no extension.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Um, it is going to be.
[CUSTOMER][NEUTRAL] 02560643
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, it's going to be [PII].
[CUSTOMER][NEUTRAL] And the date of birth, well actually, hang on, it's gonna be for her daughter [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And her date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][POSITIVE] And I can help you with that eligibility and benefit for [PII]. I am showing that her policy is active.
[AGENT][NEUTRAL] Effective date is [PII].
[AGENT][NEUTRAL] No, are you needing a breakdown?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] I actually have a breakdown that I can fax to you that does have the calendar year max, deductibles, frequencies, limitations, billing information, um, the procedures listed that are covered, are you interested in that breakdown being faxed?
[CUSTOMER][NEUTRAL] Sure, um, would that, would that fax have like a breakdown for like any wait periods missing two calls or anything on there?
[AGENT][NEUTRAL] It does. It has the, there is a 12 month waiting period on all major procedures.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It has the percentages that their um benefits are covered.
[AGENT][NEUTRAL] As well as our mailing address, fax number, payer ID.
[AGENT][NEUTRAL] And it does have the the procedures broken down as to if they're major.
[AGENT][NEUTRAL] Basic or preventive.
[CUSTOMER][NEUTRAL] OK, um, OK, and so you said there's a 12 month on major.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] OK, um, because I did have a code I want to ask you about, but if there's a waiting period, then I'm pretty sure there's gonna be a waiting period on that because I'm pretty sure that's a major code so.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, we can check that as well, but if you wanna go ahead and give me that fax number I can get this on the way for you.
[CUSTOMER][NEUTRAL] Alrighty, it's area code [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 478.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And just to verify that fax number, [PII], I'm sending this to [PII].
[AGENT][NEUTRAL] [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am it is.
[AGENT][POSITIVE] All right, that is on the way for you. And what is that code? I'll be happy to check it for you.
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] OK, um, it's code D 5820.
[AGENT][NEUTRAL] 5820
[CUSTOMER][NEUTRAL] Ma'am, for interim upper partial.
[AGENT][NEUTRAL] Yeah, that's gonna be um under major.
[CUSTOMER][NEUTRAL] I figured
[AGENT][NEGATIVE] Unfortunately.
[CUSTOMER][NEUTRAL] OK, yeah, I figured that it would be.
[AGENT][NEUTRAL] 5820, checking to see.
[AGENT][NEUTRAL] That is a covered procedure.
[AGENT][NEGATIVE] I'm not finding it.
[AGENT][NEUTRAL] 585,820 correct?
[CUSTOMER][POSITIVE] Yes ma'am correct.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Just scan it one more time.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah, I don't see that listed as a covered procedure.
[CUSTOMER][NEGATIVE] But so it must not even be a covered service.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] And um [PII] has no history either. Now on that breakdown that I just faxed you will not have the group name and number, so if you need that, I'll be happy to provide that for you.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, so the wife brought a paper in, but I can just double check with you, make sure that is correct, um.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] For the ID I had the 02560643.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then the group number she gave me on the card, it shows 15395.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK with group voluntary dental plan?
[AGENT][NEUTRAL] So that's the plan type the um group name is actually Universal Trucking.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Gnox Transportation.
[CUSTOMER][NEUTRAL] OK, I'm just gonna put universal trucking because I don't even think I'll have enough letters for I only get so many letters on my system.
[AGENT][NEUTRAL] I hear you.
[AGENT][NEUTRAL] How are you?
[CUSTOMER][NEUTRAL] I think I only get like 20 but I don't know if I'll have enough for that.
[AGENT][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][POSITIVE] But I also have it came up as well as APL.
[AGENT][NEUTRAL] Mhm. That's our
[CUSTOMER][NEUTRAL] Or American Public Life, that's would that be the insurance?
[AGENT][POSITIVE] That's right. That's us. It is.
[CUSTOMER][NEUTRAL] So that wouldn't be the OK I got that mixed up let me.
[CUSTOMER][NEUTRAL] Let me put a little arrow here.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, and so I will get that put in. I might just have to rewrite it. You said Universal trucking and what was the last part?
[AGENT][NEUTRAL] [PII], I mean sorry [PII]
[CUSTOMER][NEUTRAL] OK, that was the last part of it?
[AGENT][NEUTRAL] Transportation, sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty
[CUSTOMER][POSITIVE] Alrighty well that sounds good yeah I may just have to.
[CUSTOMER][NEUTRAL] Uh let me see if I'll have enough.
[AGENT][POSITIVE] And you should be getting that fax just any moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] Our fax has been kind of slow.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] But I haven't received it yet normally I have a little there's a phone that's attached to the fax and so I know when I'm getting a fax whenever it rings so um but sometimes it's been taking a while so.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um
[AGENT][POSITIVE] Should be getting there shortly.
[CUSTOMER][NEUTRAL] But, um,
[CUSTOMER][NEUTRAL] Kind of want to wait on the phone for you to make sure that we got it, but I know sometimes it it takes a minute.
[CUSTOMER][POSITIVE] To come our way
[AGENT][NEUTRAL] Oh, that's fine.
[AGENT][POSITIVE] Not a problem at all.
[AGENT][NEUTRAL] Are you in Lake Charles?
[CUSTOMER][NEUTRAL] Yes ma'am, we are.
[AGENT][POSITIVE] Is it finally warming up over there? It's beginning to feel a little bit better over here in Mississippi.
[CUSTOMER][POSITIVE] It is, it's starting to warm up. We actually just like
[CUSTOMER][NEUTRAL] Oh there it is.
[AGENT][NEUTRAL] Uh, look at there.
[CUSTOMER][NEGATIVE] It is, um, last week we have some low temps like in the 20s, like 27, and it's like what the heck, and it didn't get above 40 degrees.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, and in a couple days and then now it's like 70s and with Mardi Gras next week it looks like it's gonna be in the 70s so it's like.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Oh, that's good for Mardi Gras.
[CUSTOMER][NEUTRAL] Yeah, so I'm like what the heck? You were just 30 degrees.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Make up my mind, right?
[CUSTOMER][NEUTRAL] There was some more, yeah.
[CUSTOMER][NEUTRAL] Yeah and I'm like oh alright.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] And nowadays with, you know, the way the weather is, you can't take, you can't put up winter or put up summer anymore cause you never know.
[CUSTOMER][NEUTRAL] Yeah, you don't know if you need to leave the house with short sleeves and a jacket or leave the house with short sleeve, I mean long sleeves and a jacket, so, so you never know, but um.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Exactly.
[AGENT][POSITIVE] Yeah, that's right.
[CUSTOMER][NEUTRAL] Yes, so that looks like it's coming through. Um, it may take a second, um, but I should, yeah, my, my fax is.
[AGENT][POSITIVE] Wonderful.
[AGENT][NEUTRAL] To get all the way through.
[CUSTOMER][NEUTRAL] It's a newer fax machine, but it's, it's kind of old. It, it takes a second to come through, so, um, I'm sure I'll receive everything once it comes through, but, um.
[AGENT][POSITIVE] Well, do you have any questions once you get it, don't hesitate to give us a call.
[CUSTOMER][NEUTRAL] I do
[CUSTOMER][POSITIVE] Yes ma'am, I thank you so much.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] It's been my pleasure to assist you, [PII]. Thank you for calling APL and I hope you have a wonderful evening.
[CUSTOMER][POSITIVE] Yes ma'am you too thank you so much.
[AGENT][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] Bye bye.