AccountId: 011433970860
ContactId: 68de6888-969c-483d-afd6-c12fbb09d3de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290769 ms
Total Talk Time (AGENT): 119326 ms
Total Talk Time (CUSTOMER): 105448 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/68de6888-969c-483d-afd6-c12fbb09d3de_20250613T15:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I don't know
[CUSTOMER][NEUTRAL] Hey there, it's [PII], um, and I was just needing to verify patients dental benefits.
[AGENT][NEUTRAL] OK, [PII], I can help you with dental benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII] option two.
[CUSTOMER][NEUTRAL] You know,
[AGENT][NEUTRAL] OK, thank you. And what was the policy number for that patient?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's 1163069.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth is [PII].
[AGENT][NEUTRAL] OK, I show the policy active and effective 5116. Um, I can send over a fax back that outlines all the frequency duration and benefit codes and um breakdown of charges and how they pay, um, unless there's something you need to go over.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, let's see, well, I had talked to a representative early. It was a couple hours ago, um, and she was gonna send me a fax back, but I never received it, so I don't know if it's like our end or what's going on, but I never received it. Are you able to do it over the phone like a breakdown of it?
[AGENT][NEUTRAL] Uh, yeah, um, give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, anything I quote is not a guarantee of payment. It's a basic outline of the policy. Um, what, um, questions do you have?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let's see maximum and deductible.
[AGENT][NEUTRAL] Uh, there's a calendar year max of 1500, um, calendar year deductible is 50. That does apply to, um, full mouth and pano, basic and basic restorative, and major endo perio, um, and oral services, oral surgery services.
[CUSTOMER][NEUTRAL] I'll be
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alrighty, let's see, did you say, um, what was the first few, the pano and what else was it?
[AGENT][NEUTRAL] Uh, basic expenses and basic restorative.
[CUSTOMER][NEUTRAL] That it applies to
[CUSTOMER][POSITIVE] OK awesome and has anything been used or me out of that?
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Uh it doesn't look like he's used anything this year.
[CUSTOMER][NEUTRAL] OK, and then what's the co-insurance for preventative, basic, and major?
[AGENT][NEUTRAL] We're gonna do pays 100%. Um, FMX pano, Basic Expenses and Basic restorative pay 80% after a $50 deductible, and then major endoario, and prosthodontic oral surgery expenses all pay 40% after that same deductible.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alrighty, any implant coverage?
[AGENT][NEGATIVE] There's no uh implant coverage and no ortho coverage.
[CUSTOMER][NEUTRAL] Alrighty, and then any waiting periods or missing tooth cloth?
[AGENT][NEUTRAL] Um, there is a waiting period for major endoperiorosthodontic and oral surgery, which is 12 months, but that's been satisfied because he's effective 5116. And then what was the other question?
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][NEUTRAL] Is there a missing tooth cloth?
[AGENT][NEUTRAL] Yes, there is.
[CUSTOMER][POSITIVE] Alrighty, and that's everything I needed to know thank you so much.
[AGENT][POSITIVE] OK, well thanks for calling
[CUSTOMER][NEUTRAL] And um do you.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Now that we've gotten that over the phone because I had to plug it in because he's in office with us right now, do you care to try to send me the fax just so I can upload it to his chart?
[AGENT][POSITIVE] Yeah, absolutely. What's your fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, that's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] OK, yes, I will get that faxed your way. It should just take a few minutes and you should receive it um and then uh if you have any questions once you receive that you can absolutely give us a call back.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, thank you so much I appreciate it.
[AGENT][POSITIVE] OK, thanks for calling APL. I hope you have a great weekend.
[CUSTOMER][POSITIVE] You too thanks bye bye.