AccountId: 011433970860
ContactId: 0903dca4-2128-4f5f-a454-975f860bacd7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 420359 ms
Total Talk Time (AGENT): 202129 ms
Total Talk Time (CUSTOMER): 110953 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/0903dca4-2128-4f5f-a454-975f860bacd7_20250327T18:40_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII] calling from Jefferson Dental. How are you doing today?
[AGENT][POSITIVE] I'm doing great, [PII]. How about you?
[CUSTOMER][POSITIVE] Yeah, fine. Thank you so much for asking.
[AGENT][NEUTRAL] How can I help you?
[CUSTOMER][NEUTRAL] Calling to verify 10 benefits of dental. Could you please help me on that?
[AGENT][NEUTRAL] I sure can, [PII]. Go ahead and give me a good policy number, please, sir.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] 02013730
[AGENT][POSITIVE] Right, [PII], thank you so much for all that information. Now while I'm pulling this up, [PII], go ahead and give me a good return telephone call number.
[CUSTOMER][NEUTRAL] yourself.
[CUSTOMER][NEUTRAL] [PII]. It's a direct line, no extension.
[AGENT][NEUTRAL] All right, [PII], thank you for all that information. Now, your patient's name and date of birth today.
[CUSTOMER][NEUTRAL] [PII]. Date of birth will be [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Alrighty, [PII], thank you for all that information. Looks like he is the insured on this dental plan. do show the original effective date as [PII] current patient is active, but I must advise that verification of coverage is not a guarantee your payment on a claim, but you did say you want benefits. Is that correct?
[CUSTOMER][NEUTRAL] That was the
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yeah, so may I know patiently subscriber in this policy? Could you please help me in the deductibles, individual deductibles, family deductible, and yearly max amount.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] I sure can hold on just a moment while I pull up this patch bag. I'm gonna place you on a brief hold, OK? one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, OK, OK.
[AGENT][NEUTRAL] Got it.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] You
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for holding. OK, I have that faxed back a benefit pulled up. Alright, do you want to know the maximum $1500 payable per calendar year?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] With a $50 deductible.
[AGENT][NEUTRAL] For everything except preventative.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What about family deductible?
[AGENT][NEUTRAL] Family deductible is 3, people have to meet a $50 deductible each, so that's $150 for the family.
[CUSTOMER][NEUTRAL] What about percentage preventative basic and major?
[AGENT][NEUTRAL] Alright, let's see. Alright, uh, looks like preventative is paid at 100% of UCR, no deductible.
[AGENT][NEUTRAL] Basic is paid at 80% of UCR after the $50 deductible has been met.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Major is paid at 40% of UCL after the deductible is met as well up to the $1500 max payable benefit per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What about percentage preventative basic and measure?
[AGENT][NEUTRAL] Basic is 80, major is 40.
[CUSTOMER][NEUTRAL] OK, sorry, what will be the group name and group number?
[AGENT][NEUTRAL] Let's see, Universal Trucking is the group name.
[AGENT][NEUTRAL] Group number 17708.
[AGENT][NEUTRAL] And would you like that backpack of benefit today, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Could you please help me verbally?
[AGENT][POSITIVE] Oh, sure I can, or we can do both. It doesn't matter to me either way, but you can get the fax back as well.
[CUSTOMER][NEUTRAL] OK. So, may I know the schedule followed by Databas?
[AGENT][NEUTRAL] I'm sorry, what was the pay schedule or UCR?
[CUSTOMER][NEUTRAL] UCR.
[AGENT][NEUTRAL] Correct. They are not in the network.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And from deductibles any amount has been made and from a max any amount has been used?
[AGENT][NEUTRAL] Let's see the history.
[AGENT][NEUTRAL] He's not used anything.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] For this year at all. No, he hadn't used anything since [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And what about history for preventative services?
[AGENT][POSITIVE] Uh, he's good for all of it because he hadn't been in the dentist since [PII].
[CUSTOMER][NEUTRAL] [PII]. Is there any issue for FMX and Pano?
[AGENT][NEUTRAL] Give me those two codes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 0210 and 0330.
[AGENT][POSITIVE] Let's make, let's make sure.
[AGENT][NEUTRAL] 02 10, never.
[AGENT][NEUTRAL] And uh Pao, he had one done [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Sorry, 8.
[AGENT][NEUTRAL] Yeah, [PII], he had a pano.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's once every 5 years, so yeah, he, he would not be eligible for a pano right now.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So apart from this, there is no other issue that might affect the frequency, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Thank you for valuable information. And could you please help me with the call reference number?
[AGENT][NEUTRAL] Well, [PII], we don't give card reference numbers, but you can use my name in today's date. My name is [PII] and that is spelled [PII] yes, and is that all I can help you with today, [PII]?
[CUSTOMER][POSITIVE] OK, [PII]. Thank you for valuable information. That's all the information I got it. Thank you so much.
[AGENT][POSITIVE] Oh, you're welcome, [PII], and thank you for calling APO. You have a great rest of your day.
[CUSTOMER][NEUTRAL] OK, you too. Bye-bye.
[AGENT][POSITIVE] Thank you, bye bye.