AccountId: 011433970860
ContactId: 21ee200f-b2cb-4efc-8afe-769f0307c5fa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 326089 ms
Total Talk Time (AGENT): 112452 ms
Total Talk Time (CUSTOMER): 114371 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/21ee200f-b2cb-4efc-8afe-769f0307c5fa_20250314T20:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling with Ace Dental. I just called not too long ago and requested a fax back. I mean, uh, yeah, fax back. But the patient is in the office. Are you able to give me a breakdown over the phone by chance?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] You didn't get the um fax back that I sent to you. Let me look at it real quick, Ms. [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] I'm so sorry you did not get that.
[AGENT][NEUTRAL] Let me look at the patient again.
[CUSTOMER][NEUTRAL] That's OK. I didn't realize the patient was in office.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] OK, let me pull it up. It's [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, let me pull up her facts real quick so that I can look at it and see what her benefits are. You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, I've got her fax back pulled up right now. It's, it's loading. OK, I've got it.
[CUSTOMER][NEUTRAL] A and.
[CUSTOMER][NEUTRAL] Are you able to tell me if there's a group name, if there's a maximum deductible, and then what each category is covered up?
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] She has a maximum deductible.
[AGENT][NEUTRAL] And this is just to verify benefits. It's not a guarantee of payment of $150 per family, but it's $50 per covered insured.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it doesn't apply to preventative services.
[AGENT][NEUTRAL] Preventative expenses are 100% of allowable.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] And then, does she have a maximum by chance she can use a year?
[AGENT][NEUTRAL] Yes, her maximum is $500.
[CUSTOMER][NEUTRAL] And then is basic and major treatment covered on her plan?
[AGENT][NEUTRAL] Basic is covered at 80% of allowable and she does not have major.
[CUSTOMER][NEUTRAL] No me too, OK.
[CUSTOMER][NEUTRAL] Um, are you able to tell me if, uh, I'm sorry, if endodontics, perdontics, and oral surgery fall under major?
[AGENT][NEUTRAL] Uh, do you have the codes?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Um, do you want them one at a time?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] That's OK. Um, it's 3330.
[AGENT][NEUTRAL] OK let me see if I can find that code on this fax back.
[AGENT][NEUTRAL] OK, that is the 3330 is the panoramic.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] The 3330 should be a root canal.
[AGENT][NEUTRAL] OK, that's gonna be major.
[CUSTOMER][NEUTRAL] Ginger, OK.
[CUSTOMER][NEUTRAL] All right. And then for the next one, it would be 4341 for a scaling and root planning.
[AGENT][NEUTRAL] OK, let me look.
[AGENT][NEUTRAL] That is not under on the fax back, so it's not a covered expense.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] And then, let's see, for oral surgery, it would be code 7240 for surgical extraction.
[AGENT][NEUTRAL] OK, let me look.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And that is not on the fax back, so it's not a covered procedure.
[CUSTOMER][POSITIVE] Awesome. Thank you so much. I appreciate it. Um, and then for the plan.
[AGENT][POSITIVE] It's no problem at all.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh never mind, never mind you know the answer sorry.
[CUSTOMER][POSITIVE] Good thing it's Friday.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] I know, I feel you.
[CUSTOMER][POSITIVE] Thank you so much. I appreciate it. Hopefully, the fact that comes in soon. It, it might just be taking a minute.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Appreciate you calling Miss. [PII]. If there's anything else you need, please pick up the phone.
[CUSTOMER][POSITIVE] Awesome. Thank you though.
[CUSTOMER][POSITIVE] Yes ma'am, will do. You have a good one.
[AGENT][POSITIVE] OK, you too. Thank you for calling APL.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Mm bye-bye.