AccountId: 011433970860
ContactId: 45902988-d693-4f10-b15b-637dfbaa36a4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 362450 ms
Total Talk Time (AGENT): 133353 ms
Total Talk Time (CUSTOMER): 88088 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/45902988-d693-4f10-b15b-637dfbaa36a4_20250128T19:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII] with Doctor [PII] and I was calling about a patient. I just have two questions for you, um, sorry.
[AGENT][NEUTRAL] That's OK, um, couple of questions uh is this regarding a claim or benefits?
[CUSTOMER][NEUTRAL] No benefits it's benefits. I'm sorry.
[AGENT][POSITIVE] OK, no, you're perfectly fine. OK, um, [PII], really quick, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 9700.
[AGENT][NEUTRAL] Alright, thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] 00604298
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] OK, and uh what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] [PII], uh, [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that, [PII]. Uh, so this policy is active. Effective date was Janu or excuse me, [PII]. Um, do you have questions about specific, uh, procedures?
[CUSTOMER][NEUTRAL] Uh, yes, I do. OK, the first one is, um, let me see, let me get your code is PA, so that is um 0220.
[AGENT][NEUTRAL] OK. Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, what is the frequency on that?
[AGENT][NEUTRAL] OK, give me just a moment let me get it pulled up here. I'm also more than happy, of course I'll answer any questions over the phone, um, but if you'd like I can also send you a copy of the fax back, uh, that does show all of their covered procedures. OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I did
[CUSTOMER][NEUTRAL] Yes, yes, I've got that, so that helped a lot, but I still had a couple of questions.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, OK, so this was a frequency for 0220 correct?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][POSITIVE] Oh yeah, this one breaks down quite a bit differently. Um, I do believe this one.
[AGENT][NEUTRAL] Would fall under the once every 6 months.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me get that actual policy pulled up just to double check. Um, I do think so, but for this particular code, I don't, I'd rather be certain. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] I think it's because this is a bit of an older policy. I know our newer ones have.
[AGENT][NEUTRAL] Little codes next to each of the procedures and you just follow a key down at the bottom that'll tell you all the frequencies and all that fun stuff, not this one.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Here we go. I'm just gonna go.
[AGENT][POSITIVE] Limitations. Bear with me just a moment. I appreciate your patience.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, yes, I do believe that, um, every 6 months doesn't say explicitly for diagnostic or this particular code, um, but that's really the only thing that it mentions as far as.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Limitations.
[CUSTOMER][NEUTRAL] OK, so now on the 4341.
[CUSTOMER][NEUTRAL] That's the scaling, uh, and route planning. um, how many quads per visit can we do?
[AGENT][NEUTRAL] Periodontics, yeah.
[AGENT][NEUTRAL] You can do all four at once.
[CUSTOMER][NEUTRAL] OK, OK, now on the 9910, what is the frequency on that?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] 9910. Give me just a moment.
[AGENT][NEUTRAL] I don't believe that one does not appear to have a frequency, a set frequency, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK great and that's it thank you so much.
[AGENT][NEUTRAL] OK, yeah, sorry that took me a minute to find uh, did you have any other questions for me?
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][POSITIVE] That's it. Thank you.
[AGENT][POSITIVE] All right well thanks for giving us a call yeah I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] OK bye.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] You bye bye.