AccountId: 011433970860
ContactId: 43535f41-2f2b-4b9b-a08a-d3fcc69a1ca0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 697119 ms
Total Talk Time (AGENT): 139530 ms
Total Talk Time (CUSTOMER): 186468 ms
Interruptions: 3
Overall Sentiment: AGENT=1.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/43535f41-2f2b-4b9b-a08a-d3fcc69a1ca0_20250313T17:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. How are you today?
[AGENT][POSITIVE] I'm doing well, [PII] how are you doing today?
[CUSTOMER][NEUTRAL] I'm fine, thank you for asking. I was calling in regards to a patient's dental benefits and eligibility, please.
[AGENT][NEUTRAL] OK, I can help you with both eligibility and benefits. Ms. [PII], what is your call back number and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the facility name is Nieman Family Dentistry.
[AGENT][NEUTRAL] OK, thank you. I appreciate you for that information and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, the policy number is 024.
[CUSTOMER][NEUTRAL] 609.
[CUSTOMER][NEUTRAL] 82
[CUSTOMER][NEUTRAL] And the first name is [PII]. Last name is [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy. The effective date of the policy is [PII].
[AGENT][NEUTRAL] And if you give me your fax number I can send you a fax back with her benefit and fee schedule breakdown.
[CUSTOMER][POSITIVE] Oh, that'll be perfect. It is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 425.
[CUSTOMER][NEUTRAL] 973 9.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold, Ms. [PII], while I get that fax ready for you and I'll be right back.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] Come on, pop up.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Ah, there we go.
[AGENT][NEUTRAL] Uh, what the world, where to go.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me Miss [PII]. See, I'm sorry it took a little while for it to load.
[CUSTOMER][POSITIVE] You're very welcome.
[AGENT][POSITIVE] But I've got it on its way to you now.
[CUSTOMER][NEUTRAL] Oh no, it's fine.
[CUSTOMER][NEUTRAL] Perfect. Thank you so much. Um, I do have a quick question. Um, I do know that, uh, in the fax, they don't, uh, provide if the deductible has been met and if uh any of the maximum has been used. I was wondering if you can provide me with that information, please?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Absolutely. Let me look real quick.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Nothing has. OK, the deductible that's left is $50 and the maximum left is 500, so they've not used anything this year and the deductible has not.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] this year
[CUSTOMER][NEUTRAL] OK, perfect. And would, would they be um eligible for a prophylaxis and bite wings, um, say,
[CUSTOMER][NEUTRAL] Like, uh, wait, let me see when.
[CUSTOMER][NEUTRAL] Say [PII].
[AGENT][NEUTRAL] Let me look and see what they're.
[AGENT][NEUTRAL] Try is on that.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] What is the code for the prophylaxis and the bite wing?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It is D1110.
[CUSTOMER][NEUTRAL] And D 0.
[AGENT][NEUTRAL] OK, they had that
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh, I'm sorry.
[AGENT][NEUTRAL] Go ahead, go ahead.
[CUSTOMER][NEUTRAL] Oh, and the, the, the bite wings is D 0274.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, the last time that they had it done was in your office on [PII] on both procedure codes.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] So I don't they're eligible for.
[CUSTOMER][NEUTRAL] Prophy enough for.
[AGENT][NEUTRAL] Right. And the bite wings once every 12 months and the prophy is 2 for 12 months.
[CUSTOMER][NEUTRAL] Pipe wings, OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Now, is it um um uh oh it's once every 6 months, yeah. Now, is it like on the dot of 6 months or it should be like 6 months and a day?
[AGENT][NEUTRAL] 2 for 6
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It can be on the dot.
[CUSTOMER][NEUTRAL] OK. And, and same thing with the 12 month period, right? For the bright wings is it can be 12 months on the day. OK. I just wanted to make sure cause I know some um insurances they, they say it's once every 6 months, but then when uh I speak to someone, they clarify and say they have to add a day to it.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So I just wanted to make sure.
[AGENT][NEUTRAL] OK. Yes, ma'am.
[CUSTOMER][POSITIVE] But I want to thank you so much for all your help. I appreciate everything.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] No, that should be all for today, but once again, thank you so much. I appreciate your help for um this patient, and I do hope you have a great rest of the day.
[AGENT][POSITIVE] You too thank you you have a blessed one and thanks for calling.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Bye-bye, ma'am.
[CUSTOMER][POSITIVE] Thank you too bye bye.