AccountId: 011433970860
ContactId: 6d2c199b-528e-40b9-b68d-7dc65e6c7eda
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 710119 ms
Total Talk Time (AGENT): 163663 ms
Total Talk Time (CUSTOMER): 173864 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=-1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/6d2c199b-528e-40b9-b68d-7dc65e6c7eda_20250303T20:20_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes, um, I was, I called earlier and thought I was gonna get a fax and I hadn't received it yet, so I was just calling to see if I can get that for a patient.
[AGENT][NEUTRAL] OK, sure, yes, um, may I have your name?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] Alright, and may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] 02557725
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII] and [PII].
[AGENT][NEUTRAL] OK, what is that fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] That's right, yep.
[AGENT][NEUTRAL] OK, let me go ahead and send it to you while I got you on the line. Do you mind holding for me?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I started it. Uh, is it for his 3rd?
[AGENT][NEUTRAL] Well give me.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you for holding and being patient for Miss [PII]. You wanna check and see if you got that?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Sure, I'll check.
[CUSTOMER][NEUTRAL] Let me refresh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't see it yet.
[AGENT][NEUTRAL] Oh boy.
[CUSTOMER][POSITIVE] I can keep refreshing, yeah, I can keep refreshing. I don't know why we didn't get it earlier either.
[AGENT][NEGATIVE] And I'm just gonna resend it again. Sometimes when I do that, it just go right through. I don't know why, but yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Isn't that funny? I know it's like it's waiting for you to just be angry. Yeah.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] Yeah, and I gave it a little bit of time, yeah.
[CUSTOMER][NEUTRAL] I don't do unless I'm coldly. Yeah, you did, you did. Um.
[AGENT][NEUTRAL] Uh let's see.
[CUSTOMER][NEUTRAL] If not, can I get more of a full breakdown because she said a lot of it was on there but I didn't get a lot of information because I was like I'll just get what I can off the fax and then call back if needed.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and what information do you need?
[CUSTOMER][NEUTRAL] OK, so frequency, I know that he's only covered for basic um and preventative and diagnostic, um, so I was calling to see, you know, like frequencies for exam, cleaning, bye wings, that kind of thing.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so for cleanings is once every 6 months.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oral evaluation is 2 for 12 month period.
[AGENT][NEUTRAL] By wings is once per 12 month period.
[AGENT][NEUTRAL] And full m x-rays or panels are once every 5 years.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and then a panel and periapicals, are those covered under basic or preventative?
[AGENT][NEUTRAL] Those are covered under Radiograph FMX which is 80%.
[CUSTOMER][NEUTRAL] 80%. OK, um, but are the bite wings at 80% or 100%?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, that one is part of preventative. Right wings is part of preventative. Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, and then, um, the examinations, the 2 for 12 months, does that include the 0140s that share that frequency?
[AGENT][NEUTRAL] you know let me check.
[AGENT][NEUTRAL] Yeah, it's a combination of 120, 140, 150, and 160.
[CUSTOMER][NEUTRAL] OK, and um is the code 9110 covered?
[AGENT][NEUTRAL] Let me check.
[AGENT][NEUTRAL] Alright
[AGENT][NEUTRAL] I'm sorry, can you repeat that code one more time?
[CUSTOMER][NEUTRAL] That's OK, 9110.
[AGENT][NEUTRAL] OK, so that one, let me see palliative emergency, it's on the basic.
[AGENT][NEUTRAL] Which is 80%. Mhm.
[CUSTOMER][NEUTRAL] OK, is there a frequency, is there a frequency on that?
[AGENT][NEUTRAL] there's no limitations on that one.
[CUSTOMER][NEUTRAL] No, OK, and then um.
[CUSTOMER][NEUTRAL] Are fillings covered?
[AGENT][NEUTRAL] They are, yes, mhm, that's on their basic restorative and basic mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, what's the frequency on that?
[AGENT][NEUTRAL] All right, so let's see.
[AGENT][NEUTRAL] OK, so replace the existing only from place for 24 months.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Are um posterior fillings downgraded?
[AGENT][NEUTRAL] We don't downgrade.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and then are there any waiting periods on this plan? She didn't say.
[AGENT][NEGATIVE] Not for this one because it's just basic.
[CUSTOMER][NEUTRAL] Because it's not much to it.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I totally get it and the deductible is $50?
[AGENT][NEUTRAL] Hm.
[AGENT][POSITIVE] Yes, that is correct. Yes. Mhm.
[CUSTOMER][NEUTRAL] OK, and I think he's probably aged out, um, but is are fluoride or salants covered?
[AGENT][NEUTRAL] Um, the, the sealants is, um, for limited to dependent children age [PII], and then the fluoride is limited to dependent children aged [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Alright perfect um alright uh I still didn't get the facts, but I think since it's such a basic plan I pretty much I I double checked I was refreshing, um, but since it's such a basic plan, I, I think you gave me everything I needed for that. I appreciate it.
[AGENT][NEUTRAL] Oh, well.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] All right. You're welcome. Is there anything else I'm gonna help you with today, Ms. [PII]? Any other questions, concerns, and you probably will get them when you hang up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Probably, probably, yeah, I'll get 2 or 3 of them, yeah.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] Well, thank you for calling ATL. You too. Have a good evening. Bye-bye. You're welcome.
[CUSTOMER][POSITIVE] All right, well you have a great day. Thank you. Yes, thank you. Bye-bye.