AccountId: 011433970860
ContactId: 57b6ed12-f510-4f02-8dae-bad68bd8ae2c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1466530 ms
Total Talk Time (AGENT): 654597 ms
Total Talk Time (CUSTOMER): 742924 ms
Interruptions: 6
Overall Sentiment: AGENT=0.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/57b6ed12-f510-4f02-8dae-bad68bd8ae2c_20250327T18:28_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII]. I'm calling to check on our patient's dental benefits today. Can you help me out, please?
[AGENT][NEUTRAL] Sure, I could check benefits for you. Uh, I'm sorry, you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, it's going to be 01266497.
[AGENT][NEUTRAL] OK and uh what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII], and if you'd like I can send you the fax back that shows all of the covered procedures and benefit information.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK, like, uh, will it be also mentioning the percentages and the frequencies of both? OK, OK. So I have the fax number 302.
[AGENT][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] Yes, I'm ready when you are. Uh huh.
[CUSTOMER][NEUTRAL] Mhm, I'm ready. OK. [PII].
[AGENT][NEUTRAL] OK, I'm going to read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] Correct. And um just put my name in the attention if at all possible.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Yeah, I'll go ahead and send that now. You should get it, yeah, you should get it here within 10 minutes or so. Um, did you have any other questions for me at the moment, [PII]?
[CUSTOMER][NEUTRAL] [PII]. And yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, yes, I have just a few more additional inquiries to make before, uh, you going ahead. So this policy is under, uh, American Public Life, right?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And what's the claim's mailing address for [PII]?
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] And do you accept electronic claims or only papers?
[AGENT][NEUTRAL] Yes, um, so I've got a payer ID and a fax number if you'd like.
[CUSTOMER][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] So, like, do you, OK, um, like, um you have the electronic pays option as well?
[AGENT][NEUTRAL] Yes, um, our payer ID is 60801.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And uh you have done sending the fax, right? Already?
[AGENT][POSITIVE] Yes, I did just send that fax. You should be getting it shortly.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, so meanwhile I'd like to check what's the group name you have?
[AGENT][NEUTRAL] Of course one moment.
[AGENT][NEUTRAL] OK, uh, that group name is Universal Trucking.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] XPO logistics.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And uh do you know like uh this plan, like it's an open network plan or it's like a normal standard PPO plan?
[AGENT][NEUTRAL] No, it, it is open network. It pays a percentage based off of UCR.
[CUSTOMER][NEUTRAL] OK. So like this is an open network plan. OK, great. Thanks. And what's the group number you got?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Group number is 179,970.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][POSITIVE] Thank you. Just a moment. Bear with me. OK, great. Thank you so, so much for that. I understood the how the plan really works in this case. OK. And uh for this plan, like the maximum is how much, the deductible is how much?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure, so it is off of a calendar year and of course I will let you know verification of coverage is not a guarantee of payment for claims. Uh, calendar year maximum is $1500.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the deductible is 50, which does not apply to preventative expenses.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And how much the family provision for deductible is? Is it 3 times?
[AGENT][NEUTRAL] Uh, yes, uh, 150. However, Quintel is the only member listed under this policy.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK, and as you said rightly, the deductible only applies on base uh diagnos sorry, on the basic and measure we on diagnostic preventive, correct?
[AGENT][NEUTRAL] Correct, um, and then if you'll give me one moment I'll see if any of that has been used so far this year.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] No, no, we'll, we'll, we'll come to that moment really. But meanwhile, I'm just, uh, you know, trying to figure out how the benefits look like, uh, OK, on this plan, the coordination of benefit is it standard or not you?
[AGENT][NEUTRAL] Oh sure.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Yeah, that's standard.
[CUSTOMER][NEUTRAL] OK. And is there like any missing tooth cloth or waiting period in this plan that has satisfied already?
[AGENT][NEUTRAL] Sure, so there is a missing tooth clause. Uh, there was a waiting period, but it has been satisfied as the plan has been active since [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Excellent. So there has been a waiting period satisfied already. OK. So the like uh how long the waiting period was and uh on which services the waiting period were, uh, you know, applied?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Of course, sure, so it was for all major expenses, so major endodontic periodontic oral surgery did have a 12 month waiting period.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Understood rightly what you stated now. Thank you. And um just one more, uh, like I think I have asked that before as well, the 1500 maximum covers all services including diagnostic, preventive, basic, and major, right?
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEGATIVE] And you said also there is a waiting period that I got it now. And there is a missing tooth cloth as well. Is it permanent?
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, thank you so much, ma'am. And if I ask you, a patient who today I'm verifying the benefits for [PII], date of birth [PII], the subscriber as well in the plan.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Is there like any future termination date in the plan?
[AGENT][NEUTRAL] No, it is currently active.
[CUSTOMER][POSITIVE] OK, great. And uh
[CUSTOMER][NEUTRAL] As well, can you please check like out of the maximum and the deductibles, $1500 max, $50 and $150 deductible, anything matter or used or not, please?
[AGENT][NEUTRAL] Yes, I did check um none of that has been used or met so far this year.
[CUSTOMER][POSITIVE] Lovely. And uh like, aside from the calendar year max, do you have a separate lifetime max or the services or it's not covered at all?
[AGENT][NEUTRAL] No, it's just the calendar year maximum.
[CUSTOMER][POSITIVE] Excellent. I really appreciate the way you are answering. It's very prompt and, you know, instinctive. Um, thank you. And on this plan, like on this, uh, plan, particularly, is there any downgrade on crowns and fillings?
[AGENT][NEUTRAL] Of course.
[AGENT][NEGATIVE] No, um, well, no downgrades, no, not for this plan.
[CUSTOMER][POSITIVE] Thank you. And for crowns you pay those on deposit date.
[AGENT][NEUTRAL] Either one.
[CUSTOMER][POSITIVE] Excellent. For SRP do you allow all 4 cards to be done on the same day or just limited to 2 cards only?
[AGENT][NEUTRAL] Yes, no, all cards can be done on the same day.
[CUSTOMER][NEUTRAL] Of
[CUSTOMER][POSITIVE] Lovely, thank you. And there's no history for this calendar year, right?
[AGENT][NEUTRAL] Um, not for this year, no, sir.
[CUSTOMER][NEUTRAL] Thank you, ma'am. And uh like before this year, you know, uh [PII] and further down the line, do you have any last data service for cleaning examing FMX or panel on file?
[AGENT][NEUTRAL] Let me check that. Give me just a moment.
[CUSTOMER][POSITIVE] Mhm. You are so, you no problem. Thank you.
[AGENT][POSITIVE] Well thank you I appreciate it. Let's see.
[CUSTOMER][NEUTRAL] Really.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm sorry we were checking for pano and uh what else exams?
[CUSTOMER][NEUTRAL] Yeah, like any exams, um, um, cleaning, pro cleaning, bye wings, FMX or panel. I just need the, uh, precisely the last date of service, nothing, nothing less and or nothing more.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, yeah.
[AGENT][NEUTRAL] OK, the last panel that I have was from [PII].
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that was also the last uh oral examination as well, um, everything that they've had prior were uh crowns eruptions, things like that so that was gonna be the last.
[CUSTOMER][NEGATIVE] No, we will not go
[CUSTOMER][NEUTRAL] Thank you. We will not go into the further, uh like, uh, do, do you have any last date of service, any last date of service for cleaning, biting FMX uh like no FMX and panel share frequencies, right?
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] That yes, yes, they do.
[CUSTOMER][NEUTRAL] OK, so, and for profit and the periodontal maintenance do they share frequencies?
[AGENT][NEUTRAL] Let's see um.
[AGENT][NEUTRAL] Profits and what? I'm sorry.
[CUSTOMER][NEUTRAL] Prophy, like 1110. Does it shares with the 490, ma'am. Thank you. And uh exams such as 120 and 150, they share frequencies as well, right?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, absolutely.
[CUSTOMER][NEUTRAL] Thank you. And like uh you mentioned no history for bite wings, but do you have a history for prophy or no? Any loss?
[AGENT][NEUTRAL] Um, so the last bite wing that I have is for um, [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And I'm not seeing any for profit at all. I, I'm just seeing the oral evaluations. I don't see any prophies at all.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh, just to recap what I got here, on [PII], patient, uh, did the last oral evaluation along with the 0330, which, you know, a panoramic X-ray precisely. And for like bite wings, the the last date of service was [PII], correct?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][POSITIVE] Awesome, awesome. Like and like for pay rental services like an SRP pay maintenance or full mouth the bright, do you have any last date of service as well?
[AGENT][NEUTRAL] Um, I do not.
[CUSTOMER][POSITIVE] OK, great. No worries at all. Uh, fine. Uh, like, and, um, other than that, I just have a set of codes to complete the verification now. But before that, mhm, before that, you have a say in the facts. Um, having said, so I'll still go ahead and uh complete this call verbally. I really appreciate the manner you have helped me throughout and I just wanna confirm that waiting period and the missing tooth cloth both has been already satisfied with the member.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Thank you. One second. Let me just document those and yes, I have the following codes. Just let me know when you're ready.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, just a moment. Uh, patient satisfied. Let me just document my notes and then proceed to the course and finish the certification. Hang on for a moment. Patient has satisfied the waiting period.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] And then the main ingredient.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, one moment. OK, so the codes are going to be 0120014001500210022002300274. Next I got here is come on I have next as 033011101120.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 1,208,135,123,912,620.
[CUSTOMER][NEUTRAL] 27502950331033304341435543814910511056705911601060576059.
[CUSTOMER][NEUTRAL] 675-071407240911092239230.
[CUSTOMER][NEUTRAL] 9310 and 9944. Although most of these codes are listed under the facts, I'm I'm still giving you, I apologize for that. Um, but, uh, I, um, I really appreciate if you just go over the codes once with me or like uh just once for me. And uh before you begin, I just want to confirm for like coinsurances for diagnostic preventive basic and measure and that this plan is going to be like uh I have got the fas yet and it says 18,040. Is it correct? Am I reading it?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Yes, yes, that's correct.
[CUSTOMER][NEUTRAL] OK. Thank you. Thank you, ma'am. And yes, you can just go ahead with the quote. I just like to confirm two things just before you begin. Like for [PII] and [PII], the profit, do you have an age limit or no age limit?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let me check that first. Give me just a moment.
[CUSTOMER][POSITIVE] Thank you, ma'am.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][POSITIVE] Mhm. Really appreciate it. Uh, like you are, you know, very agile, you know. Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Absolutely.
[AGENT][POSITIVE] I like this kind of stuff.
[CUSTOMER][POSITIVE] Yeah, really, uh, I'm asking questions very randomly and you're giving me prompt responses. That's really, uh, you know, awesome. Yeah, like [PII] and [PII]. Is there any age limit?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, so for [PII]:10, that one's for adult [PII]20, that one is limited to dependent children under 14.
[CUSTOMER][POSITIVE] OK, [PII]r [PII]. Thank you so very much. Yes, you can go ahead now with the codes and for
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] Mhm thank you and for fluorides I think there is no age limit, right?
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So can you please.
[AGENT][NEUTRAL] So there are some uh like uh 12:05 that one is going to be for adults 12:04, that's for adults um and there are 12:01 and 1203 are for children.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, and for 1208 precisely, is it, is that a covered benefit or not?
[AGENT][NEUTRAL] 1208 is not a covered benefit, no.
[CUSTOMER][NEUTRAL] Thank you. And just a heads up for [PII], I think it's also um like to the age of, like through the age of [PII] in which patient in the month uh in which patient turns 13 as well.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] For which code? I'm sorry?
[CUSTOMER][NEUTRAL] O
[CUSTOMER][NEUTRAL] For freelance 1351.
[AGENT][NEUTRAL] Let's see, I will check that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yes, that one is also for children under 14.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you on the 14th. Awesome. You can go ahead and give me the benefits now. Thank you.
[AGENT][NEUTRAL] Of course, OK, so let's see.
[AGENT][NEUTRAL] 0120 and 0150 of course are going to be covered under preventative at 100% um frequencies for those are just going to be um I believe that's once every 6 months oh no that's oral evaluation um.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] In
[AGENT][NEUTRAL] Two, so that's two, procedures in any combination, uh, per 12 month period. So that would be 021001400150 0160 and 0180. I'll share those frequencies.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yep
[CUSTOMER][NEUTRAL] OK, just a quick heads up, 0140, is it under basic like 80%?
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] That is, yes, that one is going to be under basic.
[CUSTOMER][NEUTRAL] OK, thank you, ma'am. Please carry on to the next call. I think this is 0210, yeah.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Yes, um, so of course that's a radiograph that is going to be 80% and let's see, I think that's once every 5 years.
[AGENT][NEUTRAL] Yes, um, and then so once every 5 years and that would be for codes uh 021002770330. I'll share that frequency.
[CUSTOMER][NEUTRAL] OK. Next.
[AGENT][NEUTRAL] And then 0220.
[AGENT][NEUTRAL] And that one is covered under basic um there are no limitations for 0220.
[AGENT][NEUTRAL] Same with 0230.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] East
[AGENT][NEUTRAL] Let's see, 0274 uh is preventative, so that would be at 100%.
[AGENT][NEUTRAL] And the
[AGENT][NEUTRAL] So that's one procedure per 12 month period and that is going to be for 02700272 and 0274.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Mhm. Thank you.
[AGENT][NEUTRAL] Um, uh huh, let's see, and then we already did 0330 I believe.
[CUSTOMER][NEUTRAL] That's 1 in 12 months, right?
[CUSTOMER][NEUTRAL] Mhm. Yeah.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Um, that's uh 0274 you just provided, right?
[AGENT][NEUTRAL] Correct, yes, yes, yes, OK, and then we did already check 0330, so 1208 12:08, it was not a covered procedure.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so, uh, 1351 is a sealant that is preventative.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I think we checked that one already too, didn't we? Yeah, that one's gonna be limited to uh children.
[CUSTOMER][NEUTRAL] Um, no, I think
[CUSTOMER][NEUTRAL] Uh-huh. Yeah. So, yeah, I have checked the, like, uh sorry, so far, sorry for that. Like it's through the age of 13 as well, under, under 14, yeah, yeah. And what's the frequency precisely? Is it 1 in 3 years from the last date of service as well?
[AGENT][NEUTRAL] OK, no, no, that's OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] For which one? I'm sorry?
[CUSTOMER][NEUTRAL] 1351.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] So that's uh 11 procedure for 36 months.
[CUSTOMER][POSITIVE] OK, great. Next.
[AGENT][NEUTRAL] Yes, OK, one second, that was.
[AGENT][NEUTRAL] 2391.
[AGENT][NEUTRAL] So 239-1 is going to be uh covered under basic so that's 80 and give me just a moment let me look at those limitations.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, so provided and also patient office all that already provided me.
[CUSTOMER][NEUTRAL] Just to confirm the plan for uh.
[AGENT][NEUTRAL] OK, so maximum of 1 each tooth per 24 months and replacement of existing only if in place for 24 months. Those are the only limitations on that one so then.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] It's
[CUSTOMER][NEUTRAL] That's
[AGENT][NEUTRAL] 26, 20.
[AGENT][NEUTRAL] 26 20% is covered under major, so that is at 40%.
[CUSTOMER][POSITIVE] So that's the right.
[AGENT][NEUTRAL] And that's maximum of 1 per 7 year period.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Just have that with you.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Uh, and that is, uh, of course, limited to patients, uh, 16 and over.
[CUSTOMER][NEUTRAL] 192
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, which one?
[AGENT][NEUTRAL] Uh, that was, um, 2620.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that's for 16 and older only?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so like, uh, under 16 is not covered, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK, thank you, ma'am. Please, next.
[AGENT][NEUTRAL] Yes, so, uh, 2750 is also major. Those same limitations apply, um, so once, uh, maximum of 1 per 7 year period and limited to patients, uh, 16 and over.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And it's just.
[AGENT][NEUTRAL] Let's see 2950.
[AGENT][NEUTRAL] Is the same as well, uh, major 40% 1 per 7 year period and uh limited to uh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Age 16 and over.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm. That's 2950, right? 1 in 7 years, major, that's I think it's 40%, 1 in uh like and 16 and up only, right?
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][NEUTRAL] OK, next.
[AGENT][NEUTRAL] OK, so 3310 that is kind of our uh endedontic, that's 40% and there are no limitations.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 3330, but it's the same uh 40% no limitations.
[CUSTOMER][NEUTRAL] put you on that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 341.
[AGENT][NEUTRAL] OK, 4341 periodontic, so that is also 40%. Give me just a moment.
[AGENT][NEUTRAL] And that is um so yeah maximum of 1 each quadrant per 24 months.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, 4355 is the same, um, that's 40% and also 1 each quadrant for 24 months.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 81.
[AGENT][NEUTRAL] OK, 4381 is also at 40% and there are no limitations for that one.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My office is 4171.
[AGENT][NEUTRAL] 4910 is also at 40% and that one is maximum of 1 procedure per 6 months.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, 5110.
[AGENT][NEUTRAL] That is major, so 40%.
[AGENT][NEUTRAL] And let's see, so that's maximum of 1 per 5 year period.
[CUSTOMER][NEUTRAL] Sure 15.
[CUSTOMER][NEUTRAL] So for 5110, that's 1 in 5 year, right?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK, next.
[AGENT][NEUTRAL] And that is the same as uh 57 or excuse me, 5670 that's also going to be at 40%.
[CUSTOMER][NEUTRAL] So that's the major 1 in 5 years.
[AGENT][NEUTRAL] That's uh 40% as well and yes uh 1 per 5 year period.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 59 1159 11 is not a covered procedure under this plan.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm, uh, this is a scan right.
[AGENT][NEUTRAL] Uh, neither is 6010. That's not covered either.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEGATIVE] 6057 is also not covered.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 6059 is not covered either.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, uh, 6750 is covered, uh, that's 40% under major and then.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] That's a maximum of 1 per 7 year period and limited to patients age 16 and over.
[CUSTOMER][NEUTRAL] 10
[CUSTOMER][POSITIVE] Mhm. 16 and over. Thank you.
[AGENT][NEUTRAL] Mhm and then 7140% that is covered under basic, so 80%.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] And then let's take a look, so that's maximum of one time purchase.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, in the lifetime, right? OK.
[AGENT][NEUTRAL] Yes, I would hope so that's an extraction.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let's see 702 40.
[AGENT][NEUTRAL] Uh, that's oral surgery, so that's 40%, um, and there are no limitations on that one?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 9110 is under basic, so 80% and there are no limitations.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The 7240, uh, just to have, and just to make sure that's uh you stated that's on the major, right?
[AGENT][NEUTRAL] Uh, no. Um, oh, well, yes, so oral surgery, so 40%, yes.
[CUSTOMER][NEUTRAL] 4647.
[CUSTOMER][POSITIVE] Thank you. Next, please.
[AGENT][NEUTRAL] Of course. OK, so that was.
[AGENT][NEUTRAL] So 9223 is not a coverage procedure under this policy?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 9230.
[AGENT][NEUTRAL] Let's see
[AGENT][NEUTRAL] That is under majors, so that's 40% and no limitations on that one.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 9310 is going to be under basic, so 80% uh no limitations.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And last 1, uh, 9944 is not a covered procedure under this policy.
[CUSTOMER][NEUTRAL] OK, great. Thank you. So that's all I needed to confirm today. What's your name, please?
[AGENT][NEUTRAL] It's [PII] K A R A.
[CUSTOMER][NEUTRAL] Reference number, please?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh, so my last initial is A. Was there anything else I could help you with, [PII]llas?
[CUSTOMER][NEUTRAL] Um, [PII]ra, your last initial A. and today's date would be the reference number precisely, correct?
[AGENT][POSITIVE] Yes, sir, that's correct.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you. That's all I needed, [PII]ra. Thank you for your, uh, you know, uh, extending the call and completing the verification. You have a wonderful rest of it. Take care, ma'am.
[AGENT][NEUTRAL] Of course, yeah.
[AGENT][POSITIVE] Absolutely, yeah, it was my pleasure. Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.