AccountId: 011433970860
ContactId: 0038b128-2867-4a5d-aa00-ab65e6d0183c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 513299 ms
Total Talk Time (AGENT): 145649 ms
Total Talk Time (CUSTOMER): 127829 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/0038b128-2867-4a5d-aa00-ab65e6d0183c_20250617T13:33_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] Hi there, my name is [PII]. Um, I am calling from Aesthetic Dental Innovations. I have a patient who's coming in this morning, um, and I'm looking to get.
[CUSTOMER][NEUTRAL] Benefits and eligibility and possibly a fax back so that we can um get a breakdown of of her benefits.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, sure. I can assist you with a fax pack of benefits and I'm sorry, I didn't quite catch your name. Can you repeat your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK, and may I have a callback number just in case we get disconnected, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[CUSTOMER][NEUTRAL] And you said did you say [PII] or [PII]?
[AGENT][NEUTRAL] So, [PII].
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] OK, and um.
[CUSTOMER][NEUTRAL] Thought so, but then I was like, well, let me double check that.
[AGENT][NEUTRAL] It's OK. Alright, and may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Yes, uh, policy number is 02638738. That is what is on her card that she.
[AGENT][NEUTRAL] OK, perfect. And may I have the name and date of birth of the patient? Mhm. Yeah.
[CUSTOMER][NEUTRAL] Do you need the group number?
[CUSTOMER][NEUTRAL] Uh name is [PII] Last name is [PII].
[CUSTOMER][NEUTRAL] And her date of birth is [PII].
[AGENT][POSITIVE] Perfect. Thank you, Ms. [PII]. All right. And what is the fax number for the fax bag?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. [PII]. Is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, all right, um, do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][POSITIVE] Sure that'd be great.
[AGENT][NEUTRAL] OK, thank you, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Miss [PII]. Yeah, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I'm gonna help you with today?
[CUSTOMER][NEUTRAL] Yeah, of course.
[CUSTOMER][NEUTRAL] Um, am I able to just go over a couple of things with you just to kinda get a quick breakdown?
[AGENT][NEUTRAL] Mhm. Sure. Go ahead.
[CUSTOMER][NEUTRAL] Just a verbal breakdown, um, what is her her yearly maximum?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer, and it looks like the calendar year maximum is $500 per cover insured with the $50 deductible or $150 per family.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and then there are 2 dependents on the plan.
[AGENT][NEUTRAL] Um, let me let me check and see, make sure.
[AGENT][POSITIVE] That is correct, yes. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, is there any waiting period?
[AGENT][NEGATIVE] Not on this one. This one is just a basic dental. There's no major services on this one. So endodontics, periodontics, prosthodontic repair or surgeries are not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No major.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] So, um, just diagnostic and preventative only, is there, is there you said there is basic so like fillings.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm. Uh yes, so it's gonna be filling simple extractions, uh, any basic or basic restorative. Um, those are paid at 80% and then we have the radiograph SMX that's also paid at 80%, and then you have your preventative, which is your regular cleanings, regular checkups, and bite wings.
[CUSTOMER][NEUTRAL] And that's all at 80% as well?
[AGENT][NEUTRAL] Um, preventative is 100%.
[CUSTOMER][NEUTRAL] Preventive is 100, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so filling simple extractions.
[CUSTOMER][NEUTRAL] Was basic.
[CUSTOMER][NEUTRAL] Got it and then um can you tell me if the deductible's been met for the year already?
[AGENT][NEUTRAL] Oh, sure. Let me get that for you. One moment.
[AGENT][NEUTRAL] OK, so it looks like as of today they have not used their benefits or the the deductible, so they still have the full amount available.
[CUSTOMER][NEUTRAL] OK, alright, well, Miss, can I just get a um reference number for our call and then I'll get a hold of Ms. [PII].
[AGENT][NEUTRAL] OK, we don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any? OK. The spelling of my name is [PII].
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Oh sure.
[CUSTOMER][POSITIVE] OK great thank you so much I appreciate your time.
[AGENT][POSITIVE] You're welcome. No problem. Thank you for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Bye bye.