AccountId: 011433970860
ContactId: ed235e4e-5c45-41a5-8119-2d551aec8417
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 369570 ms
Total Talk Time (AGENT): 109470 ms
Total Talk Time (CUSTOMER): 85415 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/ed235e4e-5c45-41a5-8119-2d551aec8417_20250328T14:43_UTC.wav
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[AGENT][NEUTRAL] Calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Market Dental. How are you doing today?
[AGENT][POSITIVE] I'm good, [PII]. How can I help?
[CUSTOMER][NEUTRAL] Uh, I'm calling to verify eligibility and benefits for the patient.
[AGENT][POSITIVE] OK, I'm happy to.
[CUSTOMER][NEUTRAL] Could you please help me with that?
[AGENT][POSITIVE] Yeah, I'm happy to check on eligibility and benefits. What's the policy number?
[CUSTOMER][NEUTRAL] A minute.
[CUSTOMER][NEUTRAL] It's 614283.
[AGENT][NEUTRAL] All right, let me pull this up here one moment. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, the callback number is going to be
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And can I get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient name is [PII]. The date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you so much. So the patient is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the deductibles, individual deductibles, family deductible?
[AGENT][NEUTRAL] So the calendar, uh, the calendar year deductible is $50 per insured up to $150 for family.
[AGENT][NEUTRAL] Calendar year maximum is 1000.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And may I know the preventive basic measure percentages?
[AGENT][NEUTRAL] Uh, yes, one moment.
[AGENT][NEUTRAL] Alright, so it looks like this member's plan pays by a fee schedule and so um it's a set amount. It looks like if you need, we can send a fax back with a breakdown of the benefit amounts.
[CUSTOMER][NEUTRAL] Can we go through the call?
[AGENT][NEUTRAL] Do you have a code, codes that you would like me to check?
[CUSTOMER][NEUTRAL] Uh, um.
[CUSTOMER][NEUTRAL] It's 0120.
[CUSTOMER][NEUTRAL] 2160
[CUSTOMER][NEUTRAL] And 2740.
[CUSTOMER][NEUTRAL] I just need the percentages for 3.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] 0120.
[AGENT][NEUTRAL] The benefit amount is $15.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 21601.
[CUSTOMER][NEUTRAL] May the percentage how much, how much it is covered?
[AGENT][NEUTRAL] The benefit amount is $15.
[AGENT][NEUTRAL] The plan will pay $15 towards 0120.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm, we have the uh percentage.
[CUSTOMER][NEUTRAL] How much it is covered?
[AGENT][NEUTRAL] It's not a percentage, it's a dollar amount. It's $15.
[CUSTOMER][NEUTRAL] OK. 442,160.
[AGENT][NEUTRAL] 2160 is $35.
[CUSTOMER][NEUTRAL] Mhm. And there is no percentage for that.
[AGENT][NEUTRAL] Correct. It's just $35.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 2740, 1 moment.
[CUSTOMER][NEUTRAL] And for
[AGENT][NEUTRAL] For $2740 the plan pays $215.
[CUSTOMER][NEUTRAL] Ma'am, may I know the coincidence for preventive basic measure person?
[AGENT][NEUTRAL] I don't show any co-insurance on the plan.
[CUSTOMER][NEUTRAL] OK. May I know the group number?
[AGENT][NEUTRAL] Uh yes, one moment.
[AGENT][NEUTRAL] Um, it looks like there's no group number on the member plan.
[CUSTOMER][NEUTRAL] No group number?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] May I know the group name?
[AGENT][NEUTRAL] There's no group name or number.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else, [PII], I can check on for you?
[CUSTOMER][POSITIVE] No, that's it for my day. Thank you so much. Have a nice day.
[AGENT][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] Bye.