AccountId: 011433970860
ContactId: 11e2ce15-4811-4981-b170-0e6523b2ff0b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 659219 ms
Total Talk Time (AGENT): 197005 ms
Total Talk Time (CUSTOMER): 140804 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/11e2ce15-4811-4981-b170-0e6523b2ff0b_20250414T17:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. This is [PII], and I'm calling on behalf of the dental office for the eligibility and benefits on a recorded line. Would you please help me with that?
[AGENT][NEUTRAL] Uh, yes, I can help you with eligibility and benefits, and can I please, uh, will you spell your name for me?
[CUSTOMER][NEUTRAL] Oh sure. [PII]
[AGENT][NEUTRAL] OK, Miss [PII], what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Oh yes, please have your name, it's [PII] of [PII].
[AGENT][NEUTRAL] Thank you. And can I please get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Sure. The policy number is 025647774.
[CUSTOMER][NEUTRAL] And the patient's name is [PII], [PII].
[AGENT][NEUTRAL] OK, let me look that policy up real quick.
[AGENT][NEUTRAL] OK, I have [PII] pulled up and he does have an active policy. The effective date of the policy is [PII].
[AGENT][NEUTRAL] And if you give me your fax number, I'll send you a fax back with the benefit breakdown and fee schedule.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. One moment.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Where's my fax number? OK. So the fax number here, it's uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you so much let me repeat it [PII].
[CUSTOMER][POSITIVE] That's right.
[AGENT][POSITIVE] OK, thank you. I'm gonna put you on a quick hold while I get that text ready for you and I'll be right back.
[CUSTOMER][NEUTRAL] Sure, sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, Ms. [PII]. I have that fax on its way to you now, ma'am.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, thank you so much for that. So, uh, OK. You said, uh, the benefits breakdown and the fee schedule will be on the fax, right?
[AGENT][NEUTRAL] Yes, it will be.
[CUSTOMER][NEUTRAL] OK, thank you. And uh let me just confirm some questions with you. So that's fine, sorry.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Sure, thank you. So, uh, for this one, is the plan runs on the calendar year with the standard it will be.
[AGENT][NEUTRAL] It's on calendar year.
[CUSTOMER][NEUTRAL] OK, and the coordination of benefits, is it not standard?
[AGENT][NEUTRAL] Ma'am, you asked if it.
[AGENT][NEUTRAL] Was paid based on calendar year?
[AGENT][NEUTRAL] Is that the question?
[CUSTOMER][NEUTRAL] Uh, no, uh, that one you've already answered it. Uh, what about the coordination of benefits, the COP?
[AGENT][NEUTRAL] We don't have coordination of benefits.
[CUSTOMER][NEUTRAL] OK. And then the, is there any missing two clause on waiting period?
[AGENT][NEUTRAL] Yes ma'am, and that's on the fax back for you.
[CUSTOMER][NEUTRAL] Oh, it's already on the facts and the maximum deductibles automax as well will be on the facts.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. So what about the fillings and crowns if they are, if they are downgraded?
[AGENT][NEGATIVE] They are not.
[CUSTOMER][NEUTRAL] They are not downgraded. So for the crown, is it paid on the feet or prep date?
[AGENT][NEUTRAL] Uh, seat date
[CUSTOMER][NEUTRAL] OK. And for the scaling and route planning, are all the quotes can be done on the same day?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And then, uh sorry, uh, like, uh, suppose if the codes are not listed on the fact, uh, is it that it's not covered or?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, thank you so much for that. And the history, are there any history that might affect the frequencies of this patient?
[AGENT][NEUTRAL] Um, let me look real quick.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] What, uh,
[AGENT][NEUTRAL] Let's see, I'll tell you what he's had done.
[AGENT][NEUTRAL] Uh, procedure and this was done, um.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] He had procedure code 04341.
[AGENT][NEUTRAL] He had procedure code 04921.
[AGENT][NEUTRAL] He had procedure code 04999.
[AGENT][NEUTRAL] Procedure code 01330.
[AGENT][NEUTRAL] And procedure code 01206.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And procedure code 04341.
[CUSTOMER][NEUTRAL] What's that date of service again?
[AGENT][NEUTRAL] Was [PII].
[CUSTOMER][NEUTRAL] OK. So for that, uh, code 04341. It's for which quadrant?
[AGENT][NEUTRAL] Uh, let me look real quick.
[AGENT][NEUTRAL] I'm having to pull up the EOB so it's gonna be just a second.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Lower left, upper right, and lower right.
[CUSTOMER][NEUTRAL] The left upper right, all right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then any more history beside that?
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] OK, on [PII].
[AGENT][NEUTRAL] He had procedure 00150.
[AGENT][NEUTRAL] Procedure 00367.
[AGENT][NEUTRAL] Procedure 00274.
[AGENT][NEUTRAL] Procedure 00350.
[AGENT][NEUTRAL] Procedure 00220.
[AGENT][NEUTRAL] Also procedure 00230.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 00150.
[AGENT][NEUTRAL] 00367.
[AGENT][NEUTRAL] 00274.
[AGENT][NEUTRAL] 00350.
[AGENT][NEUTRAL] 00220.
[AGENT][NEUTRAL] 00230.
[AGENT][NEUTRAL] 00367.
[AGENT][NEUTRAL] 00274.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] 0035000220.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is that all?
[AGENT][NEUTRAL] And that's everything I've given you all the procedure codes.
[CUSTOMER][POSITIVE] OK, thank you so much for that. So that's it for this patient. So, uh, thank you so much, [PII]. I really appreciate it. And if you can help me with the call reference number.
[AGENT][NEUTRAL] Yes, you can use my name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much for that. So yeah, thank you so much for helping me out. I appreciate it.
[AGENT][POSITIVE] It's no problem at all. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] Oh, no, that's it. Thank you.
[AGENT][POSITIVE] OK, well, you have a wonderful day and thank you for calling APL. Bye-bye, Ms. [PII].
[CUSTOMER][POSITIVE] You too. Bye-bye. Take care.