AccountId: 011433970860
ContactId: f8e70cac-3bea-4642-aeee-646df61821b8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 369720 ms
Total Talk Time (AGENT): 102776 ms
Total Talk Time (CUSTOMER): 128072 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/f8e70cac-3bea-4642-aeee-646df61821b8_20250512T16:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. My name is [PII] and I'm calling on behalf of the provider's office to know about the eligibility and benefits of a patient on a recorded line. Can you please help me know that?
[AGENT][POSITIVE] Yes, I can help with eligibility and benefits. I missed your name. What was that?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] You have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And the policy number for the patient?
[CUSTOMER][NEUTRAL] Yes, the policy number is 02621212.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, so the policy is effective [PII].
[AGENT][NEUTRAL] And then I can send a fax back that outlines all of the benefits and frequencies or if there's something you need to go over on the phone we can do that as well.
[CUSTOMER][NEUTRAL] Yes, and can you please tell me the effective date group name, group number?
[AGENT][NEUTRAL] effective date is [PII].
[CUSTOMER][NEUTRAL] Oh, the group names.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yes, the group name, group number?
[AGENT][NEUTRAL] Number is 70052.
[AGENT][NEUTRAL] Group name is Oxford Global Resources.
[CUSTOMER][NEUTRAL] Oxford.
[AGENT][NEGATIVE] O X F
[CUSTOMER][NEUTRAL] Global resources, all right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Yes, yes, I got it.
[CUSTOMER][NEUTRAL] And this plan runs in a calendar year and the coordination of benefits standard, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] And in this plan, there's no missing two claws, no waiting period, right?
[AGENT][NEUTRAL] There's no waiting period. There is a missing tooth cloth.
[CUSTOMER][NEUTRAL] Um, for fillings and crowns, they are not downgraded, paid on seat there, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And for SRPL4 quotes can be done on the same day, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So can you please tell me the plan maximum, remaining maximum, and the deductible, please?
[AGENT][NEUTRAL] I guarantee of payment basic outline of the policy. They have a $500 plan year maximum deductible is for.
[AGENT][NEUTRAL] X-rays and uh basic services, it's $50 per calendar year.
[AGENT][NEGATIVE] And they have 500 available to use, and they have not met their deductible.
[CUSTOMER][NEUTRAL] And is there any orthodontic benefits for this patient?
[AGENT][NEUTRAL] Any history, is that what you said?
[CUSTOMER][NEUTRAL] No orthodontics. Is there any orthodontics benefits?
[AGENT][NEUTRAL] Oh, no, there's not.
[CUSTOMER][NEUTRAL] No, no orthodontics benefits. All right. Can you please tell me the co-insurance for preventative basic and major?
[AGENT][NEUTRAL] Preventative pays 100%. That's gonna be for exams and cleanings.
[AGENT][NEUTRAL] And basic pays 80.
[CUSTOMER][NEUTRAL] And what about for?
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] All right. Yes, go ahead.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And what about me?
[AGENT][NEGATIVE] There's no major coverage.
[AGENT][NEUTRAL] Fluoride pays 100%.
[CUSTOMER][NEUTRAL] No media coverage. All right, that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then radiographs, FMX, basic and basic restorative pay 80%.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] All right, that's great. So I just have some few quotes. Can you please tell me the coinsurance and frequency for those calls?
[AGENT][NEUTRAL] OK, how many codes do you have?
[CUSTOMER][NEUTRAL] I've got.
[CUSTOMER][NEUTRAL] 345678.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] 9, 1011, 12.
[AGENT][NEUTRAL] I can continue to fax back. The fax back has all of the codes listed, so it's a very limited plan. It'll have all the codes listed.
[CUSTOMER][NEUTRAL] [PII], 15.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] How much time will it take to receive the fax?
[AGENT][NEUTRAL] Uh, about 2 minutes.
[CUSTOMER][POSITIVE] 2 minutes. All right. That's great. And you can send me a fax back or email might be great.
[AGENT][NEUTRAL] Uh, we can just send it by fax. What's your fax?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And to your attention, is that right?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And can you please check if there is any histories that might affect the frequency of this patient?
[AGENT][NEUTRAL] Uh, no, he has no history. He just started on [PII].
[CUSTOMER][POSITIVE] Alright, that's great.
[AGENT][NEUTRAL] OK, and then I just sent the fax back, so you should receive that probably in about 1 or 2 minutes.
[CUSTOMER][POSITIVE] All right, then I guess that's all the information I needed, [PII], and may you have a great day ahead.
[AGENT][POSITIVE] Thank you for calling APL you as well.
[CUSTOMER][NEUTRAL] Bye-bye.