AccountId: 011433970860
ContactId: fb1c73ce-f416-41e9-9dea-3f6243042d02
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 391609 ms
Total Talk Time (AGENT): 136983 ms
Total Talk Time (CUSTOMER): 150097 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/fb1c73ce-f416-41e9-9dea-3f6243042d02_20250326T13:06_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am, this is [PII] calling from today's dental. Can you please check on patient eligibility and benefits for dental surgery.
[CUSTOMER][NEUTRAL] I want to go.
[AGENT][NEUTRAL] Yes, ma'am. I can barely understand you. What was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEGATIVE] I still can't hear you. It's like a noise.
[CUSTOMER][NEUTRAL] Ah.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Thank you, [PII]. And do you have a phone number I can?
[CUSTOMER][NEUTRAL] Sorry, ma'am?
[AGENT][NEUTRAL] Do you have a callback number I can get in case we get disconnected I can call you back.
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII]
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, ma'am. 02283072.
[AGENT][NEUTRAL] That was the patient's name.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, Cheer Highland and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And you were just needing benefits?
[CUSTOMER][NEUTRAL] Yes, ma'am. Eligibility and benefits with this patient plan is active?
[AGENT][NEUTRAL] Uh.
[AGENT][POSITIVE] Yes ma'am, it is active. I can help you with that. Do you want the benefits over the phone or would you like to fax back?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh yes, I need to phone and fax also.
[AGENT][NEUTRAL] OK. The effective date is [PII].
[AGENT][NEUTRAL] It is active.
[CUSTOMER][NEUTRAL] [PII]. Am I correct, ma'am?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Ah.
[AGENT][NEUTRAL] Any benefits given over the phone is not a guarantee of payment?
[AGENT][NEGATIVE] They have a $50 deduct.
[CUSTOMER][NEUTRAL] What is the group number, ma'am?
[AGENT][NEUTRAL] 70056
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The annual max for the plan?
[AGENT][NEUTRAL] 500 per calendar year.
[CUSTOMER][NEUTRAL] OK. Is there any?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Any deductible for individual and family, ma'am?
[AGENT][NEUTRAL] This is an individual policy. It is $50 on everything except for profinity.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, uh, what is the coincidence percentage for preventive basic and major services?
[AGENT][NEUTRAL] I didn't hear your question.
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] Co-insurance percentage for preventive basic and major services.
[AGENT][NEUTRAL] OK, preventative is 100% the usual and customary right?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Basic is 80%.
[CUSTOMER][NEUTRAL] Uh mm.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And major is not covered. So any endodontics, periodontics, or surgery crowns, bridges, parcels, dentures are not covered.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] What is also not covered? Am I correct, ma'am?
[AGENT][NEUTRAL] Is what covered?
[CUSTOMER][NEUTRAL] Uh, OK, ma'am. Is there any waiting period for basic and, uh, for basic restorative?
[AGENT][NEUTRAL] No waiting period.
[CUSTOMER][NEUTRAL] OK. What is the frequency for vitamins?
[AGENT][NEUTRAL] Right wings are under preventative 1 in 12 months.
[CUSTOMER][NEUTRAL] OK, for exam,
[AGENT][NEUTRAL] All exams are 2 for 12 months.
[CUSTOMER][NEUTRAL] I, I
[CUSTOMER][NEUTRAL] Panel
[CUSTOMER][POSITIVE] Thank
[AGENT][NEUTRAL] The pano, the full mouth, and the code 277, they are all combined.
[AGENT][NEUTRAL] Under basic 1 and 5 years.
[CUSTOMER][NEUTRAL] OK. For uh profile access?
[AGENT][NEUTRAL] One every 6 months.
[CUSTOMER][NEUTRAL] Flore
[AGENT][NEUTRAL] Fluoride is for children under [PII], once every 12 months.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. For free?
[AGENT][NEUTRAL] Seances of her children under [PII], once every 3 years, permanent molars only.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, ma'am. Uh, can, what is the remaining maximum available for this patient?
[AGENT][NEGATIVE] He hasn't met the deductible used any of the maximum.
[CUSTOMER][NEUTRAL] So, uh, the remaining is also $500.
[AGENT][NEGATIVE] Yes, he has no history.
[CUSTOMER][NEUTRAL] OK, ma'am. Can you please send me the details through fax?
[AGENT][NEUTRAL] OK, what's your fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I'll fax that to you.
[CUSTOMER][NEUTRAL] Mm, OK, ma'am. Can you please tell me the reference number, reference number for the call, ma'am?
[AGENT][NEUTRAL] Is there anything else I can help you with?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] Your name, ma'am?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][POSITIVE] OK, ma'am. OK. Thank you so much.
[AGENT][POSITIVE] Thank you, [PII] for calling APA. You have a good day.
[CUSTOMER][NEUTRAL] Like.