AccountId: 011433970860
ContactId: eccf7923-0005-48c6-a793-c70e1c7cc88b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 216570 ms
Total Talk Time (AGENT): 81489 ms
Total Talk Time (CUSTOMER): 107959 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/eccf7923-0005-48c6-a793-c70e1c7cc88b_20250306T16:00_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, yes ma'am. My name is [PII] I'm calling from a provider's office trying to verify eligibility.
[AGENT][NEUTRAL] OK, I can verify eligibility for you and Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] Uh yes ma'am. The policy number is uh.
[CUSTOMER][NEUTRAL] Going to be.
[CUSTOMER][NEUTRAL] Policy number is 01691413.
[AGENT][POSITIVE] OK, thank you, ma'am. Give me one moment.
[AGENT][NEUTRAL] OK, and Ms. [PII], do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Uh yes, uh [PII].
[AGENT][NEUTRAL] Thank you, ma'am, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] That is going to be [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you, ma'am. And you say you're calling to verify eligibility, correct?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. I just need to verify if he's currently active and remaining max and deductible.
[AGENT][NEUTRAL] OK, and this is for dental, correct?
[CUSTOMER][NEUTRAL] For [PII], yes, ma'am.
[AGENT][NEUTRAL] OK. Uh, yes, ma'am. I'm showing his effective date is [PII]. He is active on the policy and give me one moment.
[AGENT][NEUTRAL] 6914 and I don't show he's used any of his benefits nor um met the deductible for the year.
[CUSTOMER][NEUTRAL] Alright, so that means he's got his full, let me see, his full $1500 max and see our deductible not met and that deductible only applies to basic and major.
[AGENT][NEUTRAL] Uh, well, the deductible applies to everything but preventative.
[AGENT][NEUTRAL] So yes, sorry.
[CUSTOMER][NEUTRAL] Alrighty, yes, and um just to make sure, is that also accurate that the, the limited exam, the 0140 is at 80% and shares with all exams 2 and 12 months?
[AGENT][NEUTRAL] Uh, yes, yes, ma'am. Uh, that is basic and all exams are 2 for 12 month period.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Perfect, yes, ma'am. And my last thing is TAs are also basic 0220 at no frequency 80%.
[AGENT][POSITIVE] Correct, yes, ma'am.
[CUSTOMER][NEUTRAL] All right, yes, ma'am. Uh, other thing I need is the reference number.
[AGENT][NEUTRAL] Uh, we don't give reference numbers, but if you like, you may use my name at today's date.
[CUSTOMER][NEUTRAL] And what was your name again?
[AGENT][NEUTRAL] It's [PII], last initial [PII].
[CUSTOMER][POSITIVE] All right, yes ma'am. Thank you so much.
[AGENT][POSITIVE] You are welcome, Ms. [PII], and I thank you for calling APL. You have a great day.
[CUSTOMER][NEUTRAL] And ma'am, I apologize before I do let you go, looks like I did receive a fax back. Um, the only thing I couldn't get clear from that fax back was if posterior composites downgrade, downgraded.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] No, ma'am, there are no downgrades.
[AGENT][NEUTRAL] Whether for fillings or crowns.
[CUSTOMER][POSITIVE] All right, perfect.
[CUSTOMER][POSITIVE] Perfect. Thank you so much.
[AGENT][POSITIVE] Yes, ma'am. Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too, ma'am.
[AGENT][NEUTRAL] Bye.