AccountId: 011433970860
ContactId: 06ca139f-62f3-43db-aa46-6cca68340fd7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 239839 ms
Total Talk Time (AGENT): 78553 ms
Total Talk Time (CUSTOMER): 77798 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/06ca139f-62f3-43db-aa46-6cca68340fd7_20250422T15:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII], my name is [PII]. I'm calling from Maxwell Dental. Just want to get a little bit of information on my patient's benefits.
[AGENT][POSITIVE] All right, I'm happy to check on benefits. Do you have their policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's gonna be 02273437.
[AGENT][NEUTRAL] Alright, thank you. Let me pull this up here. And [PII], do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you. And then can I get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII] [PII].
[AGENT][POSITIVE] Perfect. So patient is active, effective date on here is [PII].
[AGENT][POSITIVE] And I'm happy to give you whatever breakdown you need verbally we can also send fax back if you need one.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] How?
[CUSTOMER][NEUTRAL] with you
[CUSTOMER][NEUTRAL] OK, alrighty, um, so I just have a few specific questions. Um, has any of the maximum of the 1500 been used and is the deductible of $50 still?
[CUSTOMER][POSITIVE] Nice.
[AGENT][NEUTRAL] OK, let's take a look here one moment.
[AGENT][NEUTRAL] Alright, so for [PII], it looks like he has the full $1500 left and the $50 deductible.
[CUSTOMER][NEUTRAL] I see
[CUSTOMER][NEUTRAL] For it, oh, give me one moment.
[CUSTOMER][POSITIVE] No I got you.
[CUSTOMER][NEUTRAL] OK, and so.
[CUSTOMER][NEUTRAL] Do 15 to 1500.
[CUSTOMER][NEUTRAL] And then um
[CUSTOMER][NEUTRAL] Code 7210. Can I know um the coverage and frequency for that code?
[AGENT][NEUTRAL] Yeah, let me take a look. 720.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] My bad.
[AGENT][NEUTRAL] All right. So, it looks like oral, it's under oral surgery, which pays 40% of UCR. Uh, there is no sort of limitation on here, just a waiting period of 12 months.
[CUSTOMER][NEUTRAL] But they've already met that right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, so there's no waiting period. They are eligible, OK, and.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Does the patient have any history for tooth number 14 or 30?
[AGENT][NEUTRAL] 14 or 30, let's take a look.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Not showing anything on file for number 14.
[AGENT][NEUTRAL] Nothing on file for 2:30 either.
[CUSTOMER][NEUTRAL] Alrighty, and my final question is, um, my last check on this insurance, the patient did not have implant coverage. Do they still not have implant coverage? 6 to 10.
[AGENT][NEUTRAL] Uh, that's
[AGENT][NEUTRAL] Correct, yes, implant placement, removal and all other related services are not covered.
[CUSTOMER][POSITIVE] Perfect thank you so much have a great day.
[AGENT][POSITIVE] You're welcome you too bye bye.