AccountId: 011433970860
ContactId: ff627302-ae56-45d9-af4d-30e9b5cf7eb6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 226360 ms
Total Talk Time (AGENT): 90077 ms
Total Talk Time (CUSTOMER): 90048 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/ff627302-ae56-45d9-af4d-30e9b5cf7eb6_20250502T13:38_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, I need to um verify benefits for um one of your um customers please.
[AGENT][POSITIVE] OK, sure, I can assist you with benefits. May I have your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And the [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh go ahead.
[AGENT][NEUTRAL] May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII] um I have most of everything I just need to know what the deductible is and the maximum out of pocket and just a couple of other things if you could give me that.
[AGENT][NEUTRAL] OK, so this is [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Mm OK. And may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] The policy number is 02339315.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] um that's the last name uh [PII].
[AGENT][NEUTRAL] OK, thank you. All right, and before I give you benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And let me see how much is this one per year.
[AGENT][NEUTRAL] OK, so this one has a calendar year maximum of $500 with a $50 deductible, and he has not used his benefit or missed his deductible as of today.
[CUSTOMER][NEUTRAL] You a little more.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Now does he have um preventative basic and major?
[AGENT][NEUTRAL] No major.
[CUSTOMER][NEUTRAL] No major what's preventative percentage.
[AGENT][NEUTRAL] Preventative is covered 100%.
[CUSTOMER][NEUTRAL] What's basic.
[AGENT][NEUTRAL] OK. Radiograph FMX is 80.
[AGENT][NEUTRAL] Basic and basic restorative is 80.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And again, no major. So endodontics, periodontics, prosthodontic repair or surgery are not covered.
[CUSTOMER][NEUTRAL] OK, let me get that done.
[CUSTOMER][NEUTRAL] OK, and does um this cover fluoride treatment?
[AGENT][NEUTRAL] It does have an age limit um for fluoride.
[AGENT][NEUTRAL] Uh, it's gonna be let's see.
[AGENT][NEUTRAL] Gonna be limited to depend on children aged [PII].
[CUSTOMER][NEUTRAL] OK, and then, um, by wings, I'm sorry, FMX and panel, how many times, um, and how many years, how many months?
[AGENT][NEUTRAL] Once per 55 years, once for 5 years.
[CUSTOMER][NEUTRAL] On for 5 years? OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And then.
[CUSTOMER][NEUTRAL] And you said um no major, right?
[AGENT][NEUTRAL] Correct, no major and and theontics and periodontics are not covered. That's major.
[CUSTOMER][NEUTRAL] OK, what about Perio SRP 4341?
[AGENT][NEGATIVE] You're not covered.
[CUSTOMER][POSITIVE] OK, all right, that's all I need thank you so much. I really do appreciate it.
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] You're welcome, Miss [PII], and thank you for calling APL. Have a good day. Bye.
[CUSTOMER][NEUTRAL] Alright bye.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank