AccountId: 011433970860
ContactId: 6149b67b-6955-4a3e-a88a-e3221f83118a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 363450 ms
Total Talk Time (AGENT): 123042 ms
Total Talk Time (CUSTOMER): 144237 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/6149b67b-6955-4a3e-a88a-e3221f83118a_20250314T15:35_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, it's [PII] from Bage Dental. I'm calling because I have a few questions about a patient's plan.
[AGENT][POSITIVE] Alright, it would be my pleasure to assist you. You said your name is [PII], correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, thank you [PII], and what is the call back number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. What is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] It is 02501322.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] That is [PII], uh, [PII].
[AGENT][NEUTRAL] Alright, thank you, and I can help you with [PII]'s policy information. Are you needing a breakdown or?
[CUSTOMER][NEUTRAL] I just have a specific questions.
[AGENT][NEUTRAL] Sure, I can help you with that. What's that question regarding [PII]?
[CUSTOMER][NEUTRAL] Alright, does the plan, uh, accept assignment of benefits?
[AGENT][NEUTRAL] It does, and that is standard.
[CUSTOMER][NEUTRAL] OK, are there any pre authorizations required on this plan?
[AGENT][NEUTRAL] Not required.
[CUSTOMER][NEUTRAL] Uh, are there, uh, procedures for an amount that that a pre-op would be recommended for?
[AGENT][NEUTRAL] Pre-op is not required.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, for a limited exams, the 0140, is it OK for [PII] to be done on the same day?
[AGENT][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I tell you, if you want a breakdown, I can fax you a breakdown, if you've not received one.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Uh, no, I've received a breakdown. These, these are just questions that are weren't on there as far as I could tell.
[AGENT][NEUTRAL] OK, got you, got you, just wanted to offer that. I understand. OK.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Um, for, uh, code 2940, uh, is there a waiting period between the billing code and when a crown could be done?
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] 812491. You know there's a 12 month waiting period on all major procedures on the policy. Uh, it's a 12 month waiting period, so crowns and bridges would not be covered until [PII].
[AGENT][NEUTRAL] But there's no waiting period in between treatments.
[CUSTOMER][NEUTRAL] I see, OK.
[CUSTOMER][NEUTRAL] And for uh.
[CUSTOMER][NEGATIVE] So the code 2391, uh, a posterior deposit molar fills downgraded.
[AGENT][NEUTRAL] We don't downgrade.
[CUSTOMER][NEUTRAL] OK, and is there no downgrade on crowns or bridges either?
[AGENT][NEUTRAL] There's not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And for um pay maintenance the code 4910 is that frequency combined or in addition to profi?
[AGENT][NEGATIVE] It is not combined.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And for SRPs in the code 4341, uh, can all requests of scaling be done on the same day?
[AGENT][NEUTRAL] They can
[CUSTOMER][NEUTRAL] And what is the minimum pocket that for SRPs?
[AGENT][NEUTRAL] Can you ask that again? I'm sorry.
[CUSTOMER][NEUTRAL] Uh, what, what is the minimum pocket depth for SRPs?
[AGENT][NEUTRAL] You know, I've never heard that, so I would not think there is a minimum depth. I'm sorry.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] It's all good.
[AGENT][NEUTRAL] That's a new question for me.
[CUSTOMER][NEUTRAL] Yes, uh, some insurances require like, uh, 4 millimeters or above.
[AGENT][NEUTRAL] Yeah, that's not required.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] And how many days must there be between a uh full month of rim and an SRP?
[AGENT][NEUTRAL] There's no um separation.
[AGENT][NEUTRAL] Time limit
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now,
[AGENT][NEUTRAL] For the, for the scaling and route planning.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's 1 per quadrant for 24 months.
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And for surgical and extractions, are they submitted to medical first?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And for uh crowns of bridges they pay on proper receipt date.
[AGENT][NEUTRAL] Either or
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And 4 bridges 6245, um, what is the number of teeth that are allowed to be missing her arch before it is downgraded to a partial denture?
[AGENT][NEUTRAL] What's the procedure code again? 62.
[CUSTOMER][NEUTRAL] 624 5.
[AGENT][NEUTRAL] There's no limitation.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And for bill dental code 2950, is it allowed the same day as the crown?
[AGENT][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] OK, and can I get a reference number?
[AGENT][NEUTRAL] Reference number is my name in today's date, and I spell my name A L I C I A, first initial last name, L as in [PII].
[AGENT][POSITIVE] Um, [PII], it was a pleasure to assist you with that additional information. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Uh, no, that'd be all, thank you.
[AGENT][POSITIVE] And thank you, [PII] for calling APL. Hope you have a wonderful day and a happy weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.