AccountId: 011433970860
ContactId: f11a0c0f-7aca-4c53-988f-d56cccb27095
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 268079 ms
Total Talk Time (AGENT): 97066 ms
Total Talk Time (CUSTOMER): 86384 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/f11a0c0f-7aca-4c53-988f-d56cccb27095_20250624T17:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Thank.
[CUSTOMER][NEUTRAL] Um, yes ma'am. I wanted to, um, verify coverage and get a breakdown of a patient's dental benefits.
[AGENT][POSITIVE] OK. Happy to check on benefits. Do we have their policy number?
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry, I just closed out of their chart.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Um, it is 754-670.
[AGENT][NEUTRAL] All right. And then if I can get patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, her name is [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] Thank you. So [PII] is active. The effective date on here is [PII].
[AGENT][POSITIVE] And I can give you a verbal breakdown over the phone. We can send a fax back, whatever works best for you.
[CUSTOMER][NEUTRAL] Yeah, I'll take a fax back but I do have a couple of specific questions.
[AGENT][POSITIVE] Yeah, absolutely, go ahead.
[CUSTOMER][NEUTRAL] So when I um called last year and got her benefits I just verify every time the patient comes in or every other time um.
[CUSTOMER][NEUTRAL] There was no group number, is that still accurate?
[AGENT][NEUTRAL] Let me double check here.
[AGENT][POSITIVE] Yes, that is still correct. Uh-huh.
[CUSTOMER][NEUTRAL] OK, what about a plan name?
[AGENT][NEUTRAL] Um, the plan, let's see.
[AGENT][NEUTRAL] It's just showing product type as select dental.
[CUSTOMER][NEUTRAL] OK and then um coverage is based on a fee schedule correct? not a percentage of.
[AGENT][NEUTRAL] Correct, yes, it is a fee schedule, mhm.
[CUSTOMER][NEUTRAL] A schedule, OK, um.
[CUSTOMER][NEUTRAL] It will her maximum deductible be on there?
[AGENT][NEUTRAL] Yes, so it's calendar year maximum of 11,000 calendar year deductible of 50.
[CUSTOMER][NEUTRAL] Has she used either?
[AGENT][NEUTRAL] Let me double check on that for you one moment.
[AGENT][NEUTRAL] Alright, looks like has the 1000 remaining and the deductible. Nothing's been used.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's see here and I guess downgrades don't technically matter we are out of network for this patient.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No missing tooth cloths, no waiting period?
[AGENT][NEUTRAL] Policy does have a missing tooth clause.
[CUSTOMER][POSITIVE] It does OK.
[AGENT][NEUTRAL] It does. It does not downgrade waiting period.
[AGENT][NEUTRAL] Don't see any waiting period listed on here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then payer ID.
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, could I request a fax back then?
[AGENT][POSITIVE] Yeah, absolutely. What's the fax number?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Should we put attention to anybody?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK. All right. Give it about 5 minutes and that should be over there. Is there anything else I can check on for you?
[CUSTOMER][NEUTRAL] Um, no, that is it. If I could just get a call reference number.
[AGENT][NEUTRAL] Absolutely. Call references my name with today's date. My name again is [PII], that's [PII], last initial [PII], and then today's date.
[CUSTOMER][POSITIVE] All right, [PII], thank you so much for your help.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye bye.