AccountId: 011433970860
ContactId: 5a4a55cd-c0d4-431e-80b5-7d7878419a23
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 358880 ms
Total Talk Time (AGENT): 112596 ms
Total Talk Time (CUSTOMER): 102608 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/5a4a55cd-c0d4-431e-80b5-7d7878419a23_20250321T17:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] My name is [PII] looking for dental benefit.
[AGENT][NEUTRAL] All right, [PII], I'm happy to check on dental benefits. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Just give me a second, it is uh.
[CUSTOMER][NEUTRAL] 02515750
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And do you have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is uh.
[CUSTOMER][NEUTRAL] It's [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. So the patient is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] So what is the annual max remaining and deductible?
[AGENT][NEUTRAL] Let's see, calendar year maximum is $1500. Calendar year deductible is going to be $50.
[CUSTOMER][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] Let me see what's been used one moment.
[CUSTOMER][NEUTRAL] Nothing, uh,
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Patient still has the $50 deductible and the calendar year amount remaining.
[CUSTOMER][NEUTRAL] What is the co-insurance, preventative, basic and measure?
[AGENT][NEUTRAL] Preventative is covered at 100% of UCR.
[AGENT][NEUTRAL] Basic is at 80% and major is at 40%.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Any waiting period?
[AGENT][NEUTRAL] There's a 12 month waiting period for all major endo and Perio expenses.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's N O PDO OK.
[CUSTOMER][NEUTRAL] Uh, alright, what is the end of period? OK, what is the coverage for, uh, 4355?
[AGENT][NEUTRAL] One moment, let me check.
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] 4355 is covered at 40%.
[CUSTOMER][NEUTRAL] Covered under major.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Covered under Pero, yeah, at 40%.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] 212. Can you check on the patient is eligible for 0140?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Let me see if there's any history on file.
[AGENT][NEUTRAL] Uh, yes, I don't show any history on file for 0140.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So 0140 not shared frequency with any other code?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 0140 does share frequency with 0120, 0150, 0160, and 0 180. It's 2 per 12 months.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] To OK, so patient is still eligible, OK.
[CUSTOMER][NEUTRAL] Any history for eno FMX?
[AGENT][NEUTRAL] Now let's see.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'm showing last FMX was on [PII]. Patient also had bite wings.
[CUSTOMER][NEUTRAL] OK, so is not eligible for buying and panel.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so just give me the reference number.
[AGENT][NEUTRAL] Call reference is my name with my last initial than today's date. My name again is [PII], that's [PII] Last initial is [PII].
[CUSTOMER][NEUTRAL] OK, thank you so much, [PII]. So [PII], can you just send me the UB dental UB or fax copy for the dental benefit.
[AGENT][NEUTRAL] A fax back, yes. What's the fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Should we mark that attention to your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That should be there in about 5 minutes, [PII]. Anything else I can do for you?
[CUSTOMER][POSITIVE] No, no, thank you so much sir have a nice day.
[AGENT][NEUTRAL] You as well bye bye.
[CUSTOMER][NEUTRAL] Bye.