AccountId: 011433970860
ContactId: 6b2dda38-9998-40f5-9705-9cb9aa1f39e6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254720 ms
Total Talk Time (AGENT): 113723 ms
Total Talk Time (CUSTOMER): 101862 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/6b2dda38-9998-40f5-9705-9cb9aa1f39e6_20250220T18:40_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I was calling to verify dental coverage on a patient.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the dental coverage. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Sure, that would be 02583342.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes ma'am [PII], [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. I am showing that the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And did you have particular questions about the fax back or you just needed a copy?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I'm trying to see, um, for could I give you some codes and see are they covered?
[AGENT][NEUTRAL] Sure, um, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what are the codes you have?
[CUSTOMER][NEUTRAL] OK, D as in donor.
[CUSTOMER][NEUTRAL] 3.
[CUSTOMER][NEUTRAL] D as in dental 0330.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then DS dental 7140.
[CUSTOMER][NEUTRAL] Come on
[AGENT][NEUTRAL] OK, just those two, or you have others?
[CUSTOMER][NEUTRAL] OK, and D as in dental?
[CUSTOMER][NEUTRAL] 0140, those three.
[AGENT][NEUTRAL] OK. So, let me see if it's all one.
[CUSTOMER][NEUTRAL] Alright
[AGENT][NEUTRAL] Alright, so 0330 is under radiographs and SMX that's covered at 80%.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 07140 is at basic um at 80%.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you need the limitations as well or just the frequency?
[CUSTOMER][POSITIVE] Yes ma'am, yes ma'am, yes ma'am.
[AGENT][NEUTRAL] OK. Um, for the full mouth X-rays and panels is once every 5 years.
[CUSTOMER][NEUTRAL] Uh yes, OK.
[AGENT][NEUTRAL] For the extraction is maximum one time per tooth.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the last one was 0140.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hold on one moment let me find that one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 00140 is not on here. 150 is, I don't know. Is it for the evaluation?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Mhm, yes ma'am.
[AGENT][NEUTRAL] OK, we have 150.
[CUSTOMER][NEUTRAL] OK, we don't.
[CUSTOMER][NEUTRAL] I have that on 50.
[CUSTOMER][NEGATIVE] So evidently that one ain't covered then.
[AGENT][NEGATIVE] Right, the 40 is not correct.
[CUSTOMER][NEUTRAL] Not covered. OK, OK, got you. OK, could I get a, um, you're gonna, you gonna send me that through a fax so I can have the address, OK, so I can have the address where to send the dental claim [PII].
[AGENT][POSITIVE] Sure, I can fax it to you.
[AGENT][NEUTRAL] What's a good fax number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] [PII], OK. And should I put attention, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes ma'am, that [PII].
[AGENT][NEUTRAL] All right, and again, just.
[AGENT][NEUTRAL] Alright, and just for the call again, all the information provided was a verification of benefits, not a guarantee of payment. And was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That'll be all, baby.
[AGENT][POSITIVE] Alrighty well thank you so much for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] Alright you as well.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye mhm bye bye. OK.