AccountId: 011433970860
ContactId: ed23cc00-b3f2-40b6-8184-791870b50f41
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 324779 ms
Total Talk Time (AGENT): 109529 ms
Total Talk Time (CUSTOMER): 85087 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/ed23cc00-b3f2-40b6-8184-791870b50f41_20250415T14:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello. Hi. Uh, my name is [PII]. I would like to verify one patient's benefit.
[AGENT][POSITIVE] Yes, [PII], I can help you with benefits today.
[AGENT][NEUTRAL] Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, yes.
[CUSTOMER][NEUTRAL] Uh, yeah, it's 02597231.
[AGENT][POSITIVE] Perfect, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And then what's a good call back number in case our call gets dropped?
[CUSTOMER][NEUTRAL] Oh yeah, it's [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And the patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, patient's name is uh [PII], and date of birth is [PII].
[AGENT][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Sorry, just one moment.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and then what benefits are you calling on today?
[CUSTOMER][NEUTRAL] Uh, dental benefit.
[AGENT][NEUTRAL] Sorry, what benefit?
[CUSTOMER][NEUTRAL] Dental.
[CUSTOMER][NEUTRAL] Dental, dentist.
[AGENT][NEUTRAL] OK. OK, so I have the policy pulled up.
[AGENT][NEUTRAL] Do you have the procedure codes?
[CUSTOMER][NEUTRAL] Uh, if the patient wants to do the preventive like uh cleaning.
[CUSTOMER][NEUTRAL] And the checkup
[AGENT][NEUTRAL] OK, so preventative expenses?
[AGENT][NEUTRAL] OK. So this is not a guarantee of payment. It's just a verification of coverage and it looks like for preventative expenses.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Under this policy, 100% of allowable.
[AGENT][NEUTRAL] It's covered.
[CUSTOMER][POSITIVE] 100%, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is there any copay or deductible?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, so it looks like they have calendar year deductible benefit and that's $50 per covered insured up to $150 per family.
[AGENT][NEUTRAL] And it says deductible does not apply to preventative services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, let me see.
[CUSTOMER][NEUTRAL] What about basic?
[AGENT][NEUTRAL] So basic expenses, 80% of allowable.
[CUSTOMER][NEUTRAL] Major
[CUSTOMER][NEUTRAL] Is cover major or not?
[AGENT][NEUTRAL] No. Major is not covered under this policy.
[CUSTOMER][NEUTRAL] No major.
[CUSTOMER][NEUTRAL] OK. Uh, could you fax me the benefits?
[AGENT][POSITIVE] Yes, ma'am, I can. Mhm.
[CUSTOMER][NEUTRAL] Right now.
[AGENT][NEUTRAL] What is your fax number?
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, no, I think that's it. Um, may I have the reference number for today's call?
[AGENT][NEUTRAL] Yes, ma'am. It's my first name, which is [PII]
[AGENT][NEUTRAL] [PII], last initial [PII], and today's date.
[CUSTOMER][NEUTRAL] And today's date, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, got it. Thank you so much, [PII]. Have a good day. Mm, OK.
[AGENT][POSITIVE] All right. Of course. Thanks for calling APL. All right. Goodbye.
[CUSTOMER][NEUTRAL] Yeah, and you will fax to me, right?
[AGENT][NEUTRAL] Yes, ma'am. I'll fax it over to you right now, OK?
[CUSTOMER][POSITIVE] Thank you so much. Have a good day. Bye-bye.
[AGENT][POSITIVE] You're welcome. You have a good day too. Bye.
[CUSTOMER][NEUTRAL] Bye.