AccountId: 011433970860
ContactId: f6eba854-43dc-4109-a938-32da2e16ccb4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 294059 ms
Total Talk Time (AGENT): 131252 ms
Total Talk Time (CUSTOMER): 67641 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/f6eba854-43dc-4109-a938-32da2e16ccb4_20250520T13:24_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling for benefits.
[AGENT][NEUTRAL] OK, [PII], you have one patient you need to get benefit information for.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, I can help you with that. And what is your callback number, [PII]?
[CUSTOMER][NEUTRAL] [PII] and it's a direct line.
[AGENT][NEUTRAL] Thank you. And what is the member's policy number?
[CUSTOMER][NEUTRAL] 02605918
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and see what type of policy are you calling on today?
[CUSTOMER][NEUTRAL] Uh, dental.
[AGENT][POSITIVE] OK, and same for our dental policies, we have fax facts of the members benefits for their plan that I'll be happy to send to you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That will have all of their information on there. So first off though, [PII], I'll need.
[CUSTOMER][NEUTRAL] OK. Uh, uh.
[CUSTOMER][NEUTRAL] Uh, so the patient has
[CUSTOMER][NEUTRAL] Uh, go ahead.
[AGENT][NEUTRAL] First off, [PII], any information that's provided today will be a verification of benefits and not a guarantee of payment.
[AGENT][NEUTRAL] So what is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, [PII], so he is the subscriber on this dental policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK, and is there any waiting period or missing tooth class?
[AGENT][NEUTRAL] There are, there is, and that is on the uh fact side as well.
[CUSTOMER][NEUTRAL] OK. And you know, under the fax that I'm able to get the downgrades and the frequency?
[AGENT][POSITIVE] The frequencies are on there. There are no downgrades.
[CUSTOMER][NEUTRAL] OK. Uh, so if there is no uh frequency or there is no specific code on that fact, so that means it's not covered or something else?
[AGENT][MIXED] Correct, if it's not on the fast track, that means it would not be covered. That is correct.
[CUSTOMER][NEUTRAL] OK. And is there any history so far?
[AGENT][NEUTRAL] Uh, no, sir. There is no history on file at this time.
[CUSTOMER][NEUTRAL] And one last thing, uh, this plan runs on calendar right?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. Just send me a fax backing the frequency.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, give me just one moment then please.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And will the facts need to be put to your attention, [PII], or is that not necessary?
[CUSTOMER][NEUTRAL] Uh, attention to [PII]. That's it.
[AGENT][NEUTRAL] Attention [PII]? OK.
[AGENT][NEUTRAL] And what is your fax number please, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and I'm just going to repeat that back to you. [PII].
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] OK [PII], so I have just sent that to you now if you will end up filing a claim for this member with APL once the claim has been processed and we do have a portal in which you can.
[AGENT][NEUTRAL] Check the claim status and that portal website is located at [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. And yeah, and may I know the reference number, please?
[AGENT][NEUTRAL] Uh, yes, so you would use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] OK. And thank you. I've been very helpful. Have a great day.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] Well, you're welcome, [PII]. So if that is all I can help you with at the moment, thank you again for calling APL and I hope you have a great day also.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.