AccountId: 011433970860
ContactId: 006aa54c-15a2-4701-b3a4-3252f5e4616f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288519 ms
Total Talk Time (AGENT): 101154 ms
Total Talk Time (CUSTOMER): 77896 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/006aa54c-15a2-4701-b3a4-3252f5e4616f_20250508T20:20_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I'm with my dentistry trying to get some member benefits.
[AGENT][POSITIVE] OK, [PII], I'm happy to check on benefits for you. Do you have your policy number?
[CUSTOMER][NEUTRAL] The policy number? Yes, it is, hold on, give me a second here, 02061497.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] And then [PII], if I could just get the patient name and date of birth.
[CUSTOMER][NEUTRAL] Uh, Earl Nevils date of birth is [PII].
[AGENT][POSITIVE] Perfect, thank you. So, patient is active. The effective date on here is [PII].
[AGENT][NEUTRAL] And then if you need us to, we can also send a breakdown with a fax back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, perfect, and you need the fax number?
[AGENT][NEUTRAL] Yep, go ahead.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Just to confirm [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Alright. So give me about 5 minutes and you should have that. Is there anything else that I can check on for you?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, can you, cause I, I'm not sure if the, the facts will have this, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, there's like 3 different codes if I can get you to check to see if the co-insurance is on that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, let's take a look. What's the first one?
[CUSTOMER][NEUTRAL] 4346.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so code 4346, I do not see listed, so it would not be covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, what about 4910?
[AGENT][NEUTRAL] Let's see, 4910.
[AGENT][NEUTRAL] So it looks like 4910 is covered. It's under pero expenses. Let me see what the limitation is. One second.
[AGENT][NEUTRAL] Um, so those expenses are covered at 40% of UCR.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's a maximum of 1 procedure for 6 months.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. And then next code would be 9110.
[AGENT][NEUTRAL] 9110, OK.
[AGENT][NEUTRAL] So 9110 is listed therefore it would be covered. Um, there is no limitation as far as frequency it's listed under basic so that would be at 80% of UCR.
[CUSTOMER][NEUTRAL] OK. And is the deductible applied to that or no?
[AGENT][NEUTRAL] Uh, yes, the only thing the deductible does not apply to is preventative.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] All right, I think the rest should be on the facts. I'm hoping anyway.
[AGENT][NEUTRAL] Yeah, and if they're not on the facts, then they're not covered, so.
[CUSTOMER][POSITIVE] OK. All right. I appreciate it. Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You have a good day.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.