AccountId: 011433970860
ContactId: 363173d6-78d2-45f3-9090-a16ba6249208
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1587939 ms
Total Talk Time (AGENT): 468806 ms
Total Talk Time (CUSTOMER): 582438 ms
Interruptions: 7
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/363173d6-78d2-45f3-9090-a16ba6249208_20250214T19:46_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling on behalf of the dental office. How are you today?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][POSITIVE] I'm good, and uh, thank you so much for asking. And I have uh uh one patient and I'm looking for limited download information on a recorded line. Could you please help me?
[AGENT][NEUTRAL] You said you're looking for limited data information?
[CUSTOMER][NEUTRAL] Oh, dental, dental information, sorry.
[AGENT][POSITIVE] Oh, OK. Well, I'll be more than happy to help you with the um dental benefits, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, contact number is [PII].
[AGENT][NEUTRAL] Thank you for that. And the member's policy number?
[CUSTOMER][NEUTRAL] Yes, I can check member's policy number we have is.
[CUSTOMER][NEUTRAL] Give me one second, it is 249-489-0.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Could you spell your name for me?
[AGENT][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] You're very welcome. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. Member's name is uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And what questions did you have in reference to their dental coverage?
[CUSTOMER][NEUTRAL] Mhm. And you found the patient Kutaha because I didn't give you the ID right yet?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Did I give you you found the patient [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, you just verified her. You gave me the policy number.
[CUSTOMER][NEUTRAL] OK, OK, just, uh, all right, what is the effect of the plant?
[AGENT][NEUTRAL] What questions did you have?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm sorry. What is the effective date of the plan, effective date.
[AGENT][NEUTRAL] The policy has been active since [PII].
[CUSTOMER][NEUTRAL] It's.
[CUSTOMER][NEUTRAL] Thank you. The plan runs on a calendar year or the fiscal year?
[AGENT][NEUTRAL] Calendar year?
[CUSTOMER][NEUTRAL] OK, what is Clem's timely filing limit?
[AGENT][NEUTRAL] There's no timely filing limit as long as the policy is active on the data service.
[CUSTOMER][NEUTRAL] There's no family
[CUSTOMER][NEUTRAL] OK. One of your reps said that 1500 max deductible $50. No use, nothing mad. Is that correct?
[AGENT][NEUTRAL] Um, hold on one moment.
[AGENT][NEUTRAL] Correct. There has been um nothing used and the deductible has not been met.
[CUSTOMER][NEUTRAL] And that amount I gave you is correct, right? 15,050.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And deductible applies to basic and major only?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And the max applies to preventive services as well, correct?
[AGENT][POSITIVE] Yes, Max supplies everything.
[CUSTOMER][NEUTRAL] OK. [PII], could you check the coordination benefit? Is it standard or not?
[AGENT][NEUTRAL] There's no coordination of benefits for the dental policies. Um, we'll process it whenever it's received.
[CUSTOMER][NEUTRAL] OK, perfect. And co-insurance for preventative basic and the major is 18,050, I mean, 18,040.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Not 50, 18,040. OK. What about simple extraction 7140? Is it basic or major?
[AGENT][NEUTRAL] Basic
[CUSTOMER][NEUTRAL] OK. But oral surgery measure, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Just a second, thank you. And do we have a waiting period missing to close on the policy?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] There is a missing tooth cloth and there's also a twelve-month waiting period for major expenses. Major includes endodontic, periodontic, prosteodontic, and oral surgery.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] OK, and the period of surgery, it's 12 months. So effective date is [PII], you said, right? From that date, 12 month applies.
[AGENT][NEUTRAL] Correct. So [PII], um, the waiting period will be over.
[CUSTOMER][NEUTRAL] OK. And no waiting period for basic, correct?
[AGENT][POSITIVE] Correct, only major.
[CUSTOMER][POSITIVE] Right. Perfect. Do you have coverage for implant or not coverage? 6 to 10?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Implant placement, removal and all related services are not covered.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Anything related to implant like uh implants supported denture?
[AGENT][POSITIVE] Correct, all related services, yes.
[CUSTOMER][NEUTRAL] OK, not covered, you said. And do you go by the codes, uh, or just the description, like if I give you 5862, would you be able to check if it's covered or not? 5862?
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] I just want to make sure I don't skip it. You said 5862?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Yeah, there's no 5862.
[CUSTOMER][NEUTRAL] Yeah, it's
[CUSTOMER][NEUTRAL] OK. And 5863 is covered?
[AGENT][NEUTRAL] I'm not showing 5863 either.
[CUSTOMER][NEUTRAL] OK, do you have the coverage for 6061?
[CUSTOMER][NEUTRAL] 6061.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] crown over implant.
[AGENT][NEUTRAL] Yeah, I just have to go through the fact back to look for that code on there. Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] And can you also send me the fax so I'll check while, you know, so that will save the time.
[CUSTOMER][NEUTRAL] Can I give you the fax number?
[AGENT][NEUTRAL] Um, would you like me to look for the code first or send the fax?
[CUSTOMER][NEUTRAL] Oh yes, yes, you can look at first and then found it.
[AGENT][NEUTRAL] And it was [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm not showing that um code on this list either.
[CUSTOMER][NEGATIVE] Not not listed there.
[CUSTOMER][POSITIVE] No issue.
[CUSTOMER][NEUTRAL] And now can you check the close guard 994449945.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] All cluser guards are listed under major.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, what was the code that you gave you gave to?
[CUSTOMER][NEUTRAL] 9945.
[AGENT][NEUTRAL] 9945 is not a covered code, um, but there is a code for cual guard on here. Did you need the limitation?
[CUSTOMER][NEUTRAL] You have the 9944 is covered.
[AGENT][NEUTRAL] No, 9940.
[CUSTOMER][NEUTRAL] 0 9944.
[AGENT][NEUTRAL] I understand what you're saying. The code that I'm giving 9940 is the Oluguard code on this list.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] OK, it's old code, right? Not a new one.
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] It's alright, so I can ask the other question.
[AGENT][NEUTRAL] What is a good fax number for you?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, the fax number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do I need to put attention [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And I'll ask other question.
[CUSTOMER][NEUTRAL] And you have the fax number [PII], correct?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, that's that's the number you gave me.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Perfect. And could you please check, composite fillings are downward to amalgamma now.
[AGENT][POSITIVE] There's no downgrades.
[CUSTOMER][NEUTRAL] Mhm. And you already sent the fax, so I'll check while we're talking.
[AGENT][NEUTRAL] No, sir. I haven't sent it yet. I'm sending it now.
[CUSTOMER][NEUTRAL] No, sir, I haven't sent it yet.
[CUSTOMER][NEUTRAL] OK, OK. I'll wait.
[AGENT][NEUTRAL] Yeah, I'll let you know when I send it. I'm just waiting for it to come up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you have any more questions?
[CUSTOMER][NEUTRAL] OK, so until the [PII].
[CUSTOMER][POSITIVE] Yes, I do actually. Uh, prosthetic period on preparation date.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] There's no specification. It could be either or.
[CUSTOMER][NEUTRAL] OK. What about exam pro fee by train frequency and the percentage?
[AGENT][NEUTRAL] Profies and cleanings are once every 6 months, that's under preventative at 100.
[AGENT][NEUTRAL] Bite wings are once per 12 month period. That's 80, actually, hold on one moment. Bite wings are now 100. Yeah, bite wings are 100% under preventative.
[CUSTOMER][NEUTRAL] 1
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Exams are 22 for 12 month period.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Exam, you said once in 6 months, right, before?
[AGENT][NEUTRAL] No, exams are 2 per 12 month period. So yes, that's the same as 1 per 6 months.
[CUSTOMER][NEUTRAL] Mhm. And the Pro phase 1 in 6 months you said correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What about Aromax and the panel?
[AGENT][NEUTRAL] FMX and panels are once every 5 years.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] At 80%.
[CUSTOMER][NEUTRAL] 8
[CUSTOMER][NEUTRAL] 80%.
[CUSTOMER][NEUTRAL] OK. And the 0220?
[AGENT][NEUTRAL] Are you wanting me to check the code for?
[CUSTOMER][NEUTRAL] Perry.
[CUSTOMER][NEUTRAL] 0220, yes, PA.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] In general, like per epical.
[AGENT][NEUTRAL] OK, so that's under basic at 80%?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEGATIVE] There's no frequency.
[CUSTOMER][NEUTRAL] No issue. Can you check the code 0150 comprehensive exam?
[AGENT][NEUTRAL] It's under preventative at 100%?
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] The limitation is, hold on one moment, limited to two or evaluations in any combination with 120, 40, 50, 60, or 80 per 12 month period.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm, OK, and 140 also preventative correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] What about fluoride in the sealant 1208 and 1351?
[AGENT][NEUTRAL] 1208 is not a covered code, but fluoride and sealants are under preventative at 100%.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And want to, what about the frequency for fluoride in the ceiling?
[CUSTOMER][NEUTRAL] And age limit as well?
[AGENT][NEUTRAL] For sealants, um, hold on one moment.
[AGENT][NEUTRAL] Maximum of 1 procedure per 36 months.
[AGENT][NEUTRAL] Applications made to permanent molar teeth only.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And limited to dependent children under age [PII].
[CUSTOMER][NEUTRAL] Mhm and you
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] For the flu ride, were you looking for children or adult or both?
[CUSTOMER][NEUTRAL] Uh, both, it's OK. You can just give me the coverage.
[CUSTOMER][NEUTRAL] 41208 or 106?
[AGENT][NEUTRAL] Uh, once both of those clothes are not covered on this policy.
[CUSTOMER][NEGATIVE] And fluoride is not covered at all for the plan, not even for child.
[AGENT][NEUTRAL] Fluoride is covered. 011206 and 011208 are not covered codes.
[CUSTOMER][NEGATIVE] But you're telling fluoride is covered first and then you're telling not covered.
[AGENT][NEUTRAL] So when you get the facts back, there's different codes on here. Code [PII], and [PII] are the codes used on this policy for fluoride. The two codes you provided or not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] No problem, thank you and the code [PII] is covered?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] 0277 is covered or no?
[CUSTOMER][NEUTRAL] 02 77.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][POSITIVE] Thank you, we are almost done.
[AGENT][NEUTRAL] It's covered under basic at 80%.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, limited to one X-ray procedure.
[AGENT][NEUTRAL] With 00210277 or 330 per five-year period.
[CUSTOMER][NEUTRAL] OK, 402-77 you said. What about uh nitrous oxide 9230?
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Sure, I know.
[AGENT][NEUTRAL] It's under major at 40%?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And uh can you.
[AGENT][NEGATIVE] There's no frequency.
[CUSTOMER][NEUTRAL] Can you check 4910 period maintenance?
[AGENT][NEUTRAL] Hold on 1 2nd.
[CUSTOMER][NEUTRAL] Hold on one second.
[AGENT][NEUTRAL] That's major at 80%.
[CUSTOMER][NEUTRAL] That's major 8%.
[AGENT][NEUTRAL] Um, one procedure per 6 months.
[CUSTOMER][NEUTRAL] 80%, right? Basic you said or major?
[AGENT][NEUTRAL] Hold on one moment let me go back up. You said 4910?
[CUSTOMER][NEUTRAL] OK you said 410. Correct.
[AGENT][NEUTRAL] This is major at 40%.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It shares with the prophy or in addition to prophy?
[AGENT][NEUTRAL] It just has the same frequency as prophy.
[CUSTOMER][NEUTRAL] So it doesn't, they, they are combined or no?
[AGENT][NEUTRAL] They're not combined, it just has the same frequency.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now what about 4341?
[AGENT][NEUTRAL] That's also under periodontic at 40%.
[AGENT][NEUTRAL] The limitation is maximum 1 each quadrant per 24 months.
[CUSTOMER][NEUTRAL] OK, what about 4 to 63?
[AGENT][NEUTRAL] 426-3 is under periodontic at 40%.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me see if there's a frequency. Hold on one moment.
[CUSTOMER][POSITIVE] Good good
[AGENT][NEUTRAL] Maximum 1 each quadrant per 24 months.
[CUSTOMER][NEUTRAL] Maximize.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the 4 to 66.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Right. 4266.
[AGENT][NEUTRAL] 4266.
[AGENT][NEUTRAL] 4266 is not a cover code on this policy.
[CUSTOMER][NEUTRAL] OK, 4 to 67.
[AGENT][NEGATIVE] 4267 is not covered on this policy.
[CUSTOMER][NEUTRAL] No issue. Can you check?
[CUSTOMER][NEUTRAL] 4 29 50.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] 2950 is not a covered code on this policy.
[CUSTOMER][NEUTRAL] 2.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you know probably you said.
[CUSTOMER][NEUTRAL] And 2920.
[AGENT][NEUTRAL] 29, 20. Hold on one moment.
[AGENT][NEUTRAL] This is under major at 40%. It's a crown.
[AGENT][NEUTRAL] Um, let me see what the frequency is.
[AGENT][NEUTRAL] Maximum of 1 per seven-year period and limited to patients age [PII] and over.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] OK, what about 6930 just the percentage.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Major at 40.
[CUSTOMER][NEUTRAL] OK. 4355.
[AGENT][NEUTRAL] Major at 40.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] The limitation is
[CUSTOMER][NEUTRAL] 434.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][POSITIVE] Yes, yes, yes, go ahead.
[AGENT][NEUTRAL] The limitation is one of, I'm sorry, maximum of 1 each quadrant per 24 months.
[CUSTOMER][NEUTRAL] OK, once in 24 months. 4346.
[CUSTOMER][NEUTRAL] 4346.
[AGENT][NEUTRAL] Yes, I heard you. I'm, I'm going through a list of codes. Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][POSITIVE] Oh, OK, OK. Sorry about that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, 4346 is not a covered code on this policy.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, 4381.
[AGENT][NEUTRAL] 4381 is under periodontic at 40% with no limitation.
[CUSTOMER][NEUTRAL] 28 at 40%.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Under 80 40% with no frequency you said right?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] For 4381, yes.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK, and 2962?
[AGENT][NEUTRAL] 292.
[CUSTOMER][NEUTRAL] 2
[AGENT][NEUTRAL] 2962 is not a covered code on this policy.
[CUSTOMER][NEUTRAL] Code on this policy.
[CUSTOMER][NEUTRAL] 262 not covered, OK.
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] Let me check if anything else. What about 9 to 310? We're almost done.
[AGENT][NEUTRAL] 9310 is under basic at 80% with no limitation.
[CUSTOMER][POSITIVE] Alright thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] 9310 basic.
[CUSTOMER][NEUTRAL] And 923 9.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] 923-9 is not covered on this policy.
[CUSTOMER][NEUTRAL] 9243.
[AGENT][NEUTRAL] 9243 is not on this list?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So it's 40%?
[AGENT][NEGATIVE] It's not on the list.
[CUSTOMER][NEUTRAL] OK, OK. 9248.
[AGENT][NEGATIVE] It's not on the list.
[CUSTOMER][NEUTRAL] Mm, OK, just go.
[CUSTOMER][NEGATIVE] 5982 also not covered.
[AGENT][NEUTRAL] You said 5982?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] 5
[AGENT][NEUTRAL] Yeah, 5982 is not on this list either.
[CUSTOMER][NEUTRAL] OK. And 0277, were you able to find it somewhere?
[AGENT][NEUTRAL] 0277 is under basic at 80%.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] I don't know why I can't find it.
[AGENT][NEUTRAL] These are bite wings, um, we gave them.
[CUSTOMER][POSITIVE] Oh, you're right.
[AGENT][NEUTRAL] The frequency of 1 for 5 years.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right. And the 0220 is also basic, correct?
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] 020.
[AGENT][POSITIVE] Correct, with no limitation.
[CUSTOMER][POSITIVE] OK, no worries.
[CUSTOMER][NEUTRAL] And uh.
[CUSTOMER][NEUTRAL] 0210 you said under basic that's fine. And now can you check for this policy how long after SRP can we do period maintenance and guideline?
[AGENT][NEGATIVE] There is no specification.
[CUSTOMER][NEGATIVE] No specification.
[CUSTOMER][NEUTRAL] Now, can you check, uh, can you do any treatment on the same day with the 0140?
[AGENT][NEUTRAL] Yes, there's no, there's no specification with that code, um, only the limitation for the oral evaluation.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm, no problem and now 2950.
[CUSTOMER][NEUTRAL] It's not there, OK.
[CUSTOMER][NEUTRAL] Can you check, uh, Priya is required or suggested for how many dollars and above?
[AGENT][NEUTRAL] Pre-authorization is not required.
[CUSTOMER][NEUTRAL] Not required.
[CUSTOMER][NEUTRAL] 2950 I see it's covered, right? I think it's on the list.
[CUSTOMER][NEUTRAL] Under major list.
[AGENT][NEUTRAL] OK, if you see it on the list, then it is a covered code.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] If it's not on the list, it won't be.
[CUSTOMER][NEGATIVE] If it's not there on the list, right, then it's not covered.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Mm, you're right.
[CUSTOMER][NEUTRAL] OK. And uh you, what, what about your pre-op you said?
[AGENT][NEUTRAL] Pre-authorization is not required?
[CUSTOMER][NEUTRAL] Not required, is that OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Bear with me.
[CUSTOMER][NEUTRAL] OK, what's the call reference number, [PII]?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name and today's date. The first initials of my last name is [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] my name and the the.
[CUSTOMER][NEUTRAL] And uh, one of your reps said that there is no history for FMX on the panel. Is that right? 40,210 and 0330.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] What were the two codes?
[CUSTOMER][NEUTRAL] 021010330
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] That's right. OK.
[CUSTOMER][NEUTRAL] No history on that. All right, so that's all I wanted to confirm for this patient.
[CUSTOMER][POSITIVE] I do appreciate your help.
[AGENT][POSITIVE] You're very welcome. You also, and thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] I hope you have a nice day.
[CUSTOMER][POSITIVE] Bye, take care.