AccountId: 011433970860
ContactId: 3b7f7794-dfec-497c-af4c-ae0257dfb9b8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 289130 ms
Total Talk Time (AGENT): 127634 ms
Total Talk Time (CUSTOMER): 88769 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/3b7f7794-dfec-497c-af4c-ae0257dfb9b8_20250109T22:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from my dental office to verify some benefits for a patient.
[AGENT][POSITIVE] All right, [PII], I'm happy to verify benefits for you today. Do you have their policy number?
[CUSTOMER][NEUTRAL] Yes I do. It's 02560626.
[AGENT][POSITIVE] Alright thank you so much let me pull this up here.
[AGENT][NEUTRAL] And if I could get patient's name and date of birth?
[CUSTOMER][NEUTRAL] I have [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you so much. So the patient's plan is active. The effective date on this is [PII]. And if you need, we can send a fax back with a breakdown of benefits also.
[CUSTOMER][POSITIVE] Yes, ma'am, that would be great.
[AGENT][POSITIVE] Absolutely. What's a good fax number for you?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] OK, number [PII], correct?
[CUSTOMER][POSITIVE] Yes, yes, ma'am. Correct.
[AGENT][POSITIVE] All right. That is headed your way. Is there anything else I can check on for you?
[CUSTOMER][NEUTRAL] Yes, can I verify that our doctor is in network with, with this policy?
[AGENT][NEUTRAL] Um, we can double check and take a look. Let's see.
[AGENT][NEUTRAL] OK, so for this plan it looks like it pays by UCR. There's no network actually required. Some of our plans participate in like a PPO network with Carrington, but this one doesn't.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Cause I know we do do carrot but yeah you said UCR?
[AGENT][NEUTRAL] So this
[AGENT][NEUTRAL] Yeah this one just pays by UCR fee schedules, so usual customary reasonable fee.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I, before I let you go, let me ask a couple of questions. Um, what, for the exams, would they share frequency with each other?
[AGENT][NEUTRAL] But like.
[CUSTOMER][NEUTRAL] Uh, would that be on the breakdown?
[AGENT][NEUTRAL] Yeah, it is on the breakdown, so let's see, um, so like profile and cleanings are frequency is once every 6 months.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Exams would be 2 for 12 months.
[AGENT][NEUTRAL] Uh, bite wings are once per 12 months.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] FMX and panos are once every 5 years.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then crowns and bridges once every 7 per tooth, partials and dentures are once every 5.
[CUSTOMER][NEUTRAL] OK, and if we were to do a pero for um SRP 4341, did you do two or four quads?
[AGENT][NEUTRAL] Let's see 4341.
[AGENT][NEUTRAL] Uh, the only limitation I see with that is a maximum of 1 each quadrant per 24 months.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And for the, uh, is there a waiting period for SRP or Imperial maintenance?
[AGENT][NEUTRAL] Let's see here.
[AGENT][NEUTRAL] Yeah, so it looks like there's a waiting period of 12 months.
[CUSTOMER][NEUTRAL] 12 months. Thank you. And excuse me, last question, do molar crowns downgrade?
[AGENT][NEGATIVE] They do not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's what I was doing and he said no. OK, thank you so much. Is it OK if I get a reference number for this call?
[AGENT][NEUTRAL] Absolutely. Call reference is going to be my name with my last initial and then today's date. My name again is [PII], that is spelled [PII] Last initial to my name is going to be [PII].
[CUSTOMER][POSITIVE] OK, and today's date. OK, thank you so much you have a great rest of your day.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] You too. Take care.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye bye.