AccountId: 011433970860
ContactId: 7f3c378e-2112-4aae-8bfd-9655c32c9642
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 271579 ms
Total Talk Time (AGENT): 114155 ms
Total Talk Time (CUSTOMER): 87123 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/7f3c378e-2112-4aae-8bfd-9655c32c9642_20250303T14:18_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] Yes, hi, I'm calling from Sm Scott Family Dental. My name is [PII], and I was trying to um get benefits and verify my um
[CUSTOMER][NEUTRAL] On my patient's insurance.
[AGENT][NEUTRAL] OK, I can help you with the eligibility and benefits, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, yes, ma'am, it's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Um, yes, it is 0257977777.
[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] Mhm
[CUSTOMER][NEUTRAL] Um, yeah, the first name is [PII] Last name is [PII] and the date of birth is [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, it, it'll pop up.
[CUSTOMER][NEUTRAL] Yeah, what is his date of birth?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, here we go.
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and I am showing that the policy is active, it's been effective since [PII].
[CUSTOMER][POSITIVE] Thanks.
[AGENT][NEUTRAL] And did you need a copy of the fax back or did you have particular questions about it?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, it's, um, the wife is, um, here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Ms. [PII]. Mhm.
[AGENT][NEUTRAL] So the calendar year max is $1500 per covered insured?
[CUSTOMER][NEUTRAL] 1500?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] The deductible is $50 per person up to $150 per family, and it doesn't apply to preventative.
[CUSTOMER][NEUTRAL] It doesn't apply the premium, OK.
[AGENT][NEUTRAL] Um, prevent, preventative is covered at 100%.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Radiographs, FMX, basic, and basic restorative are all at 80%.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Basic is that how much?
[AGENT][NEUTRAL] 80.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um the major?
[AGENT][NEUTRAL] So major for us includes endodontic, periodontic, prosodontic, and oral surgery. That's all covered at 40%, and there is a 12-month waiting period, so they won't be able to use their major until [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, trophies and cleanings are once every 6 months.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Exams are 2 per 12 month period. The exams are paired, so it could be 120, 140.
[AGENT][NEUTRAL] Um, 50, 60, or 80.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Um, bit wings are once per 12-month period.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Full mouth X-rays and panels are once every 5 years.
[AGENT][NEUTRAL] Crowns and bridges are once every 7 years per tooth.
[CUSTOMER][NEUTRAL] Um, that's fine. Can you fax me the rest?
[AGENT][NEUTRAL] Oh, sure. What's a good fax number for you?
[CUSTOMER][NEUTRAL] Yeah, I'm sorry. Yeah, I just needed the basic, yeah, um, it is.
[CUSTOMER][NEUTRAL] 779.
[CUSTOMER][NEUTRAL] Um 285.
[CUSTOMER][NEUTRAL] I mean, uh, yeah, 2858693.
[AGENT][NEUTRAL] And should I put attention [PII]?
[CUSTOMER][NEUTRAL] Uh, yeah, that's fine.
[AGENT][NEUTRAL] OK, that was 770285-8693?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, and I'll go ahead and send this over to you now. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] Alright. Well, thank you for calling APL [PII]. I hope you have a good day.
[CUSTOMER][POSITIVE] You too, ma'am. Thank you so much.
[AGENT][POSITIVE] You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Mhm