AccountId: 011433970860
ContactId: 58ec9b69-89ec-4741-a4b9-2b45ab2fd9e8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 247279 ms
Total Talk Time (AGENT): 62037 ms
Total Talk Time (CUSTOMER): 98573 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/58ec9b69-89ec-4741-a4b9-2b45ab2fd9e8_20250331T13:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh yes. My name is [PII]. I'm calling from a provider's office. How are you today?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] I'm good, thank you. I received a fax. I've just got some questions about a patient's plan, please.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII], no extension.
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It is 02550384.
[AGENT][NEUTRAL] OK, and please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, and just submit advise you that verification of coverage does not guarantee payment of claims. And what's your question?
[CUSTOMER][NEUTRAL] Is there no major coverage?
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] I don't, I mean, I
[CUSTOMER][NEUTRAL] I don't see any.
[AGENT][NEGATIVE] Right under this policy, there's no major coverage.
[CUSTOMER][NEUTRAL] So there's no Pario or endo.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Let me see, can you tell me that there's no pero end though, but do you cover the 40, the 4910, the perio maintenance?
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Or if I don't see that number on this fax, does that mean it's not covered?
[AGENT][POSITIVE] That's correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, then I don't, I, I didn't.
[CUSTOMER][NEUTRAL] I didn't see it.
[CUSTOMER][NEUTRAL] OK, so this is kind of a limited, and I am looking at the maximum is 500, correct?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yes, ma'am, 500 per calendar year.
[CUSTOMER][NEUTRAL] OK. And I, I wanted to make sure I looked at, so in FMX.
[CUSTOMER][NEUTRAL] Uh, the 0210 is 80% and so is a single PA 0220.
[AGENT][POSITIVE] Yes ma'am, that's correct.
[CUSTOMER][NEUTRAL] Do you see a frequency on the single PA because I didn't.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] And what's that code one more time?
[CUSTOMER][NEUTRAL] 0220.
[AGENT][NEUTRAL] It's not on there, but it'll fall in line with the 210. So it's, it'll be covered under the um the um limited to one procedure every five-year period.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. All right, um.
[CUSTOMER][NEUTRAL] And this plan, does it renew on in January or does it renew on the effective date?
[AGENT][NEUTRAL] Um, it's per calendar year, renews in January.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, all right, you are awesome thank you you have a wonderful day.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, you're awesome thank you.
[AGENT][POSITIVE] OK. Thank you, [PII], for calling APL. You have a great day as well. Mm bye.
[CUSTOMER][POSITIVE] Thank you. Bye.
[AGENT][NEUTRAL] Mm