AccountId: 011433970860
ContactId: 2b58327a-feec-4f68-bf7b-51ce11055c3d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288160 ms
Total Talk Time (AGENT): 113670 ms
Total Talk Time (CUSTOMER): 96333 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/2b58327a-feec-4f68-bf7b-51ce11055c3d_20250616T15:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, hi, I'm calling from a dental office. I'm trying to get information on a patient's dental plan.
[AGENT][NEUTRAL] OK, I can help you with dental benefits. Um, could I get your name and a good callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And it's [PII], no extension.
[AGENT][NEUTRAL] OK, thank you, [PII]. And do you have the policy number for that patient?
[CUSTOMER][NEUTRAL] Uh yes, give me one second. It looks like um the number they gave us is 02566066.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII] 6574.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] As far as
[AGENT][NEUTRAL] OK, it looks like the policy is active and effective [PII]. Um, do you want me to fax over a fax back that outlines everything that's covered frequency and duration?
[CUSTOMER][NEUTRAL] Um, yes, if you're able to, but I'm also trying to see if we're in network because I, I don't know what plan this is.
[AGENT][NEUTRAL] Um, if there's not a network for this policy, they can see any dentist they like.
[CUSTOMER][NEUTRAL] OK, so there's um no network is there a group name?
[AGENT][NEUTRAL] Uh group name is.
[AGENT][NEGATIVE] That's Universal Trucking Anderson Flatbed.
[CUSTOMER][NEUTRAL] Universal trucking.
[CUSTOMER][NEUTRAL] Anderson.
[CUSTOMER][NEUTRAL] Is there a group number?
[AGENT][NEUTRAL] And group number is.
[AGENT][NEUTRAL] 1456 4.
[CUSTOMER][NEUTRAL] Um, and then is there a payer ID for like electronic claims?
[AGENT][NEUTRAL] Yes, payer ID is 60801.
[CUSTOMER][NEUTRAL] And um is there a fee schedule or do we just go by our office fees?
[AGENT][NEUTRAL] Uh, yeah, it's just based on UCR.
[CUSTOMER][NEUTRAL] OK, UCR and uh claims address?
[AGENT][NEUTRAL] Claims address is [PII].
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And it's [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And then can you repeat the zip code one more time?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK and then is there a deductible or an annual maximum?
[AGENT][NEUTRAL] It's not a guarantee of payment basic outline of the policy. It's $1500 for calendar calendar year maximum, and then $50 deductible applies to FMX basic, basic restorative major endo perio prosthodontics, and oral surgery.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK and then what is the name of this insurance plan?
[AGENT][NEUTRAL] Um, well, we're American Public Life, and then the name of the plan is
[AGENT][NEUTRAL] D as in Delta 4 FFS.
[AGENT][NEUTRAL] U T B A.
[CUSTOMER][NEUTRAL] OK, and then can I get like a general breakdown like what is the percentage of coverage for like preventive diagnostic, basic, and major?
[AGENT][NEUTRAL] Preventative pays 100%. FMX basic, basic restorative major all pays or basic restorative pays 80% after a $50 deductible.
[AGENT][NEUTRAL] Major endopperiorosthodontic and oral surgery pays 40% after that same deductible, and there's a 12-month waiting period.
[CUSTOMER][NEUTRAL] And OS and you said base falls under with FMX.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK perfect and do AS and you said there is a 12 month waiting period with Major.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and then you said uh date was [PII] and then I can give you our fax number. I just needed a little bit of information to enter it in.
[AGENT][NEUTRAL] OK, and the fax number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, that was [PII].
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] OK, I'll get this fax back sent over and is there anything else I can help with today?
[CUSTOMER][POSITIVE] Um, no, that is it, thank you.
[AGENT][POSITIVE] OK, thank you for calling ATL. Have a great day.
[CUSTOMER][NEUTRAL] Yes sir.
[AGENT][POSITIVE] Thank you. Bye-bye.