AccountId: 011433970860
ContactId: f513646a-10a3-42d2-8945-4f5be201d3a6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 381869 ms
Total Talk Time (AGENT): 121943 ms
Total Talk Time (CUSTOMER): 185258 ms
Interruptions: 2
Overall Sentiment: AGENT=-0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/f513646a-10a3-42d2-8945-4f5be201d3a6_20241230T21:19_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello there. This is [PII]. I'm looking for dental benefit for my patient.
[AGENT][NEUTRAL] I can assist you today. Could you provide me with the spelling of your name?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And what's a good call back number for you and that policy number?
[CUSTOMER][NEUTRAL] [PII] with no extension direct line and the policy number is 01 02150283.
[AGENT][NEUTRAL] Can you verify this patient's name and date of birth?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes, [PII] [PII].
[AGENT][NEUTRAL] And you're calling to verify benefits and eligibility, this policy is terminated.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] And the member has no active policy here at American Public Life.
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] Uh, can I get the termination date?
[AGENT][NEUTRAL] [PII], it was effective [PII].
[CUSTOMER][NEUTRAL] OK, ma'am. Uh, I have like one more patient left, uh, with the same. Uh, can you also provide me the benefit for that patient?
[AGENT][NEUTRAL] Sure, give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Could you provide me with the spelling of your name again?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII], right.
[CUSTOMER][NEUTRAL] Yes, yes, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the next policy number?
[CUSTOMER][NEUTRAL] 01822695.
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] And the.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] Thank you. This policy has been active since [PII], I'm sorry, since [PII] and it's currently active.
[CUSTOMER][NEUTRAL] Any future termination date?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK. And uh what will be the group name and group number?
[AGENT][NEUTRAL] This member has a yearly max.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] The group number is 17626. 17626. The group name is Universal Trucking.
[CUSTOMER][NEUTRAL] Yeah, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh ma'am, uh for this patient is a provider in or out of network.
[AGENT][NEUTRAL] Could you repeat yourself?
[CUSTOMER][NEUTRAL] Uh is the provider in or out of network?
[AGENT][NEGATIVE] There is no network.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEGATIVE] The member does not have a network.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh what will be the annual maximum?
[AGENT][NEUTRAL] The annual maximum is $1500 per calendar year with a $50 deductible that does not apply to preventative services, and this is not a guarantee of benefits, just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] Any family deductible?
[AGENT][NEUTRAL] 150 per family.
[CUSTOMER][NEUTRAL] Sandal sandals.
[CUSTOMER][NEUTRAL] OK. And uh what will be the coverage percentage for diagnosis, basic, major, and also?
[AGENT][NEUTRAL] Preventative is covered at 100, basic is covered at 80, and major is covered at 40.
[CUSTOMER][NEUTRAL] And also
[CUSTOMER][POSITIVE] benefits.
[AGENT][NEGATIVE] I don't think it covers it.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEGATIVE] Ortho is not covered.
[CUSTOMER][NEUTRAL] And uh any waiting period of missing tooth cloths?
[AGENT][NEUTRAL] Um, there is a missing tooth cloth. However, the waiting period exalted, so they met their waiting period.
[AGENT][NEUTRAL] In [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And ma'am, for this patient, there is an appointment date on [PII]. So I would like to know whether the policy remains the same or there is a change in the benefits.
[AGENT][NEUTRAL] Yes, they will, they will remain the same. The costs will remain the same and the benefits will start over.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, then. Uh, can I get the history for this year, for this patient and any history from previous year that might affect the current frequency?
[AGENT][NEUTRAL] The procedure code D1110 was completed on [PII].
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And D 110.
[AGENT][NEUTRAL] Was completed [PII].
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This is all the history. Uh, no other basic on major history.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK. Uh
[CUSTOMER][NEUTRAL] Then, uh, for the station, I have like a few codes. Can I get your frequency and percentage?
[AGENT][NEUTRAL] I can send you a fax back if you would like.
[CUSTOMER][NEUTRAL] Then, uh, ma'am, can you just spell your name for me?
[AGENT][NEUTRAL] [PII], and today's date as a reference.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK. Thank you. Have a good day and bye for now.
[AGENT][NEUTRAL] Uh, what's your fax number?
[CUSTOMER][NEUTRAL] Uh, no need to send that, ma'am.
[AGENT][NEUTRAL] You already have one?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yes, I just want to verify it.
[AGENT][POSITIVE] Alrighty well thanks for calling APL have a great day.
[CUSTOMER][NEUTRAL] Yeah.