AccountId: 011433970860
ContactId: 28a70287-321d-4492-878f-c6bf9c3b1f80
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223740 ms
Total Talk Time (AGENT): 93607 ms
Total Talk Time (CUSTOMER): 88859 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/28a70287-321d-4492-878f-c6bf9c3b1f80_20250523T16:34_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi there, my name is [PII]. I'm calling from Elite Smiles. I am just wondering if there is like a benefit or um eligibility like breakdown that we could get back to us or if that's something that we need to go over the phone.
[AGENT][NEUTRAL] Um, no, we can send you a fax back with a breakdown of benefits, absolutely. Do you have the patient's policy number?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Oh, yeah, OK.
[CUSTOMER][POSITIVE] Yeah, so long as I can have a deal with my partner, sure.
[CUSTOMER][NEUTRAL] It's 02569285.
[AGENT][NEUTRAL] At the end, did you say 285 or 287? I'm sorry.
[CUSTOMER][NEUTRAL] It's OK, 285.
[AGENT][NEUTRAL] OK, I just wanna make sure I heard you right there.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] There is no reason.
[AGENT][NEUTRAL] And then what is the patient's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] It's [PII] and then let me look at his date of birth. I'm sorry.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] All right, thank you. So the patient is active. Uh, the effective date on here is [PII].
[AGENT][NEUTRAL] And then what is a good fax number to send the fax back to?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, just to confirm, [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Alright, so give it about 5 minutes and you should have that. Is there anything else that I can help with?
[CUSTOMER][NEUTRAL] Um, yes, I just, before you go, I wanted to verify what the schedule we should be using.
[AGENT][NEUTRAL] Alright, so yeah, it looks like this one just pays by UCR, um, and then the fax back will have the percentages of what it pays towards that.
[CUSTOMER][NEUTRAL] OK great and then is do any of the um codes downgrade like crowns or filling.
[AGENT][NEUTRAL] No, there is no downgrades on the plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then the only other thing that might not be on there is is there a missing tooth clause or waiting period.
[AGENT][NEUTRAL] Um, so the policy does have a missing tooth clause.
[CUSTOMER][NEUTRAL] on
[AGENT][NEUTRAL] And there is a waiting period that will be listed on there also. The waiting period applies to all major expenses. That does include endoperio and oral surgery, which is 12 months.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][POSITIVE] OK wonderful and then the timely filing limits and that's the last question I'm sorry.
[AGENT][NEUTRAL] No, not a problem. There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK, great. If I could just get a reference number.
[AGENT][NEUTRAL] Absolutely. Call reference is my name with my last initial and then today's date. My name again is [PII], that's [PII] and then my last initial is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much. I hope that you have a great day.
[AGENT][NEUTRAL] You too. Bye-bye.
[CUSTOMER][POSITIVE] Thanks bye bye.