AccountId: 011433970860
ContactId: 078101f3-281b-415e-8b6a-8a76d91b73cf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 418700 ms
Total Talk Time (AGENT): 155213 ms
Total Talk Time (CUSTOMER): 104992 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/078101f3-281b-415e-8b6a-8a76d91b73cf_20250530T14:02_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check dental benefits.
[AGENT][NEUTRAL] OK, I can verify benefits for you, and, and what is the policy number, please?
[CUSTOMER][NEUTRAL] 02479073
[AGENT][POSITIVE] OK, thank you. And a good callback number?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] OK. You had called earlier and I called that number and someone asked for your extension. Do you have an extension in case this call gets disconnected again?
[CUSTOMER][NEUTRAL] Uh, direct line?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Uh [PII] [PII].
[AGENT][NEUTRAL] OK, I'm showing his effective date is [PII]. He is active on the policy. Now you just need a general breakdown of benefits or I can send you a fax back.
[CUSTOMER][NEUTRAL] Uh, any general benefits. Uh, before that, is there a waiting period on this plan?
[AGENT][NEUTRAL] There is a 12-month waiting period for major services.
[CUSTOMER][NEUTRAL] Is that, I think it is satisfied, right, already? You said [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so there is no waiting period. One moment. Is there a missing tooth cloth?
[AGENT][POSITIVE] There is a waiting period, he just satisfied it.
[AGENT][NEGATIVE] There is a missing tooth clause.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] OK. Can I get the annual max, deductibles, and the coinsurances?
[AGENT][NEUTRAL] Not a guarantee of payment, just a verification coverage to ensure it has a benefit max up to $1500 per calendar year with a $50 deductible that is applied to everything but preventative services.
[AGENT][NEUTRAL] Preventative pays 100% of UCR.
[AGENT][NEUTRAL] Basic, basic restorative FMX panoramic pays at 80% and for major services it pays at 40% and major does include endoperio and oral surgery.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] And um is there an auto benefit on this plan?
[AGENT][NEGATIVE] Or though it's not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, what is the percentage for the code 0431?
[AGENT][NEUTRAL] Major services, there is 40% of UCR.
[CUSTOMER][NEUTRAL] What is the frequency?
[AGENT][NEUTRAL] Once every 24 months.
[CUSTOMER][NEUTRAL] Is it for 0431?
[AGENT][NEUTRAL] 0431. I'm sorry.
[AGENT][NEUTRAL] Give me one moment.
[AGENT][NEGATIVE] Actually, it's not covered. I don't show it on the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Percentage for 0220.
[AGENT][NEUTRAL] How many more codes are you needing to check?
[CUSTOMER][NEUTRAL] Uh, like, uh, 66 or 7 coats.
[AGENT][NEUTRAL] Give me the rest of the codes, please.
[CUSTOMER][NEUTRAL] OK. 0220
[CUSTOMER][NEUTRAL] Uh, next is 0240.
[CUSTOMER][NEUTRAL] Uh, one moment.
[CUSTOMER][NEUTRAL] 13
[CUSTOMER][NEUTRAL] 55
[CUSTOMER][NEUTRAL] 2991.
[CUSTOMER][NEUTRAL] 4355
[CUSTOMER][NEUTRAL] 4910
[CUSTOMER][NEUTRAL] 4260
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] 2920.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEGATIVE] The 220 falls under basic and there is no frequency. 240, the same falls under basic, no frequency. 4355 is major at 40% and it's once every 24 months.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] You gave me a 435 5 twice.
[CUSTOMER][NEUTRAL] Yeah, no that
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Anyway, um, 2991 is not covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 4910 is major, once every 6 months.
[AGENT][NEUTRAL] 4260.
[CUSTOMER][NEUTRAL] Do they share the trophy?
[AGENT][NEUTRAL] Now,
[AGENT][NEUTRAL] 4260 is major and it's once every 36 months.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And 2920.
[AGENT][NEGATIVE] Uh, it's not covered.
[AGENT][NEUTRAL] Oh, I'm sorry. It's once every 7 years and it's major.
[CUSTOMER][NEUTRAL] Do you pay the major services on sea date or prep date?
[AGENT][NEUTRAL] Either or.
[CUSTOMER][POSITIVE] OK, got it. Yes, that's it. Uh, thank you so much. Can I get the reference number?
[AGENT][NEUTRAL] Uh, if you like, you may use my name in today's date.
[CUSTOMER][NEUTRAL] Could you spell out your name?
[AGENT][NEUTRAL] [PII] last initial [PII]
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Bye.
[CUSTOMER][NEUTRAL] OK.