AccountId: 011433970860
ContactId: 063c31a4-c561-4c2b-909f-2d87d535fa8e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 370660 ms
Total Talk Time (AGENT): 129883 ms
Total Talk Time (CUSTOMER): 68183 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/063c31a4-c561-4c2b-909f-2d87d535fa8e_20250212T17:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII] calling from provider's office to check on dental benefits.
[AGENT][POSITIVE] All right, [PII], I'm happy to check on benefits today. What is the patient's policy number?
[CUSTOMER][NEUTRAL] 02494791
[AGENT][NEUTRAL] Thank you. One moment please. Let me pull this up.
[AGENT][NEUTRAL] And if I could get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient is [PII], [PII].
[AGENT][POSITIVE] All right, thank you so much. So the patient does have an active plan. The effective date is [PII].
[AGENT][POSITIVE] And if you need we can fax a fax back with a breakdown of benefits or we can give those verbally whatever you prefer.
[CUSTOMER][NEUTRAL] I just need some information. Can you tell me the amount used from the maximum deductible and orthodontics?
[AGENT][NEGATIVE] Yes, one moment. This plan actually doesn't have orthodontic coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mount use from the maximum deductible?
[AGENT][NEUTRAL] So the patient has met the $50 deductible. The calendar year amount maximum is $1500. They've used $93.60. The remaining balance is $1,406.40.
[CUSTOMER][NEUTRAL] $93.60 used. OK, can I have the
[CUSTOMER][NEUTRAL] Uh, coverage percentage for preventive basic image is 180, 40?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Any waiting period on the policy?
[AGENT][NEUTRAL] Uh, there's a 12-month waiting period for major endoperio and oral surgery.
[CUSTOMER][NEUTRAL] Endoperio and oral surgery.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So the waiting period is on basic or major?
[AGENT][NEUTRAL] The waiting period is on major.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you check the code 0140 sorry 0220 and 0330. Is that basic 80%?
[AGENT][NEUTRAL] 0220 and 0330, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] 0220 falls under basic.
[AGENT][NEUTRAL] 0330 falls under radiograph FMX expenses.
[AGENT][NEUTRAL] That's covered at 80% also.
[CUSTOMER][NEUTRAL] OK. And can I have the preventive history for this number?
[AGENT][NEUTRAL] Let me check. One moment.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Last date of service on file is [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] That is for?
[AGENT][NEUTRAL] Uh, they had procedure 02200140.
[AGENT][NEUTRAL] Their last um oral evaluation before that was on [PII]. They had bite wings on that date as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What was the date? [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] For white wing, OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And for pan?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Uh, the last pano was on [PII] as well.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And what was the last day of service for [PII].
[AGENT][NEUTRAL] Uh, one moment.
[CUSTOMER][NEUTRAL] Prophylaxis.
[CUSTOMER][NEUTRAL] Well.
[AGENT][NEUTRAL] I'm checking here. One moment, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] I don't show any history on file for [PII].
[CUSTOMER][NEUTRAL] Any history of ropy?
[AGENT][NEUTRAL] I'm not seeing anything.
[CUSTOMER][POSITIVE] All right. Thanks for your assistance, Doctor [PII] for the call.
[AGENT][NEUTRAL] That would be my name with my last initial and today's date. My name again is [PII], that's [PII] Last initial is [PII].
[CUSTOMER][POSITIVE] Thanks for assistance. Have a nice day.
[AGENT][NEUTRAL] You too, [PII], bye bye.