AccountId: 011433970860
ContactId: 4fe06b71-0b99-42c9-b5a1-2ec301f07103
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 177669 ms
Total Talk Time (AGENT): 70946 ms
Total Talk Time (CUSTOMER): 69996 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/4fe06b71-0b99-42c9-b5a1-2ec301f07103_20250328T19:57_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, uh, good afternoon. My name is [PII]. I'm calling from JS Dental Clinic. Um, I'm calling to check dental benefits for a patient and, uh, I just want.
[AGENT][POSITIVE] So I can assist you with today.
[CUSTOMER][NEUTRAL] Huh?
[AGENT][NEUTRAL] Sure, I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] 02492087.
[AGENT][NEUTRAL] So, could you verify the patient's name and date of birth that you're requesting benefits for today?
[CUSTOMER][NEUTRAL] Um, first name is [PII]. Last name, um, [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. This policy has been active since [PII] and it's currently active.
[CUSTOMER][NEUTRAL] OK, may I know if our provider is in network with this plan?
[AGENT][NEUTRAL] This policy doesn't have a network. It's a PPO. It's not a PPO or HMO. It's just a standard dental policy that covers dental services, and the provider will be paid as long as the assignment of benefits are signed.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, OK, and may I know how much is the remaining maximum?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mm, the member has 1500 per calendar year.
[AGENT][NEUTRAL] And this is not a guarantee of beneficial just a disclaimer of the policy's coverage and they utilize $219.22.
[AGENT][NEUTRAL] So they have $1280.78 remaining.
[CUSTOMER][NEUTRAL] OK, you said that the maximum benefit is 1800?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] No, the maximum benefit amount is $1500 per calendar year, and this is not a guaranteed benefit it's just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] 0, 15
[CUSTOMER][NEUTRAL] OK, and also may I know if this patient has any history for tooth number 1718, and 19?
[AGENT][NEUTRAL] What is your code?
[CUSTOMER][NEUTRAL] Um, any.
[CUSTOMER][NEUTRAL] Any history, um.
[AGENT][NEGATIVE] No history on file, no.
[CUSTOMER][NEUTRAL] OK, no history on file.
[CUSTOMER][NEUTRAL] Um, and how much is the coverage for procedure code 2330?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let me look it up 233.
[AGENT][NEUTRAL] What is the description of that code?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Restorative one surface interior.
[AGENT][NEUTRAL] 80%
[CUSTOMER][NEUTRAL] 80%.
[AGENT][NEUTRAL] No downgrade.
[CUSTOMER][POSITIVE] OK, yeah, I think that, OK, yeah, that's all for now thank you so much.
[AGENT][POSITIVE] Alrighty, well it was a pleasure speaking with you, [PII]. Thanks for calling APA. You have a great day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye.