AccountId: 011433970860
ContactId: 92a6db90-bf6d-4271-b4f4-5f79013ea76a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 371850 ms
Total Talk Time (AGENT): 143368 ms
Total Talk Time (CUSTOMER): 128348 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/92a6db90-bf6d-4271-b4f4-5f79013ea76a_20250224T14:05_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] Um, I am needing to go over some coverage.
[CUSTOMER][NEUTRAL] Um, for a patient.
[AGENT][POSITIVE] OK, well, I can help you with the benefits. May I have your name and a good contact number?
[CUSTOMER][NEUTRAL] My name is [PII] um [PII].
[AGENT][NEUTRAL] Thank you for that and [PII], may I have a good contact, I'm sorry, may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is 447-984-792.
[AGENT][NEUTRAL] OK, do you have their APL policy number? Is that a social or something?
[CUSTOMER][NEUTRAL] No you're fine you're fine.
[CUSTOMER][NEUTRAL] Uh, I guess so. That's the one that I gave them last time when they, whenever I called.
[AGENT][NEUTRAL] So is there social?
[CUSTOMER][NEUTRAL] I guess so.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It looks like it would be.
[AGENT][NEUTRAL] I think so. Let me see.
[AGENT][NEUTRAL] And this is for the um the health policy or dental?
[CUSTOMER][NEUTRAL] Dental
[AGENT][NEUTRAL] Dental? OK, hold on one moment.
[AGENT][NEUTRAL] I believe I just found it.
[AGENT][NEUTRAL] And can you verify his date of birth and first and last name?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that. And the APL policy number is 233.
[CUSTOMER][NEUTRAL] Hi
[AGENT][NEUTRAL] 0419.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the policy has been active since [PII]?
[CUSTOMER][NEUTRAL] Pro
[AGENT][NEUTRAL] And all the information provided is a verification of benefits, not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 60
[AGENT][NEUTRAL] And what questions did you have about their coverage?
[CUSTOMER][NEUTRAL] I have, sorry, I'm trying to wait out some stuff real quick, um, on implant 6010, what is that? Is that a covered benefit?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hold on one second, let me pull up the fax back 6010.
[AGENT][NEUTRAL] 62.
[AGENT][NEUTRAL] Um, I don't see 6010 on the fax back, so it's not a covered code, but implants, placements, removal are not covered on the policy.
[CUSTOMER][NEUTRAL] OK, what about Endo?
[CUSTOMER][NEUTRAL] 3330.
[AGENT][NEUTRAL] Uh, is, you're saying are in those services covered?
[AGENT][NEUTRAL] 3030.
[CUSTOMER][NEUTRAL] I know they're covered. What are they covered at? Are they covered at basic or major?
[AGENT][NEUTRAL] So endodontic, periodontic, proteodontic, and oral surgeries is all under major at 40%.
[CUSTOMER][NEUTRAL] OK, what about, um, extractions?
[AGENT][NEUTRAL] Um, do you have a code?
[AGENT][NEUTRAL] I can look on the fax back 7210.
[CUSTOMER][NEUTRAL] 70 to 10.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] There's
[AGENT][NEUTRAL] That's under oral surgery.
[CUSTOMER][NEUTRAL] So is that covered?
[AGENT][NEUTRAL] At 40%.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then what about sedation? I didn't see it 9230.
[AGENT][NEUTRAL] 9230 is under, what is this category, Major at 40%.
[CUSTOMER][POSITIVE] It all works.
[CUSTOMER][NEUTRAL] OK, what about 4341?
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] the other day.
[CUSTOMER][NEUTRAL] Uh, check out.
[CUSTOMER][NEUTRAL] I had a car that
[CUSTOMER][NEUTRAL] To a
[AGENT][NEUTRAL] 43.
[CUSTOMER][NEUTRAL] Was because the lady I actually.
[AGENT][NEUTRAL] 4341 is under periodontic 40%.
[CUSTOMER][NEUTRAL] OK, and then 4910.
[AGENT][NEUTRAL] I'm also on periodontic 40%.
[CUSTOMER][NEUTRAL] What about 4381?
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] Also periodontic at 40%.
[CUSTOMER][NEUTRAL] OK, and on the SRP can we do the 4341, can we do all four quads at the same time?
[AGENT][NEUTRAL] Um, yes, there's no specification except maximum of 1 each quadrant per 24 months.
[CUSTOMER][NEUTRAL] OK, what about 9944?
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] I didn't undo the bank bag.
[CUSTOMER][NEUTRAL] The other day there's probably more change in there.
[AGENT][NEUTRAL] 9944. No, I'm not showing that um code on the fax back, so it's not a cover code.
[CUSTOMER][NEUTRAL] Yeah, when I got back from the bank, uh huh.
[CUSTOMER][NEUTRAL] OK, and then what about 1354?
[AGENT][NEUTRAL] Let's see 13.
[AGENT][NEUTRAL] 54, no, 54 is not on the fax back. 51 is.
[CUSTOMER][NEUTRAL] Um, what about 2991?
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] I thought it was weird.
[AGENT][NEUTRAL] 2991.
[CUSTOMER][NEUTRAL] And she put it in there because she was hoping they would break it but I it but they didn't so.
[AGENT][NEUTRAL] Yeah, I'm not showing 2991 either.
[AGENT][NEUTRAL] Let me double check because there's a few pages. No, I don't see it.
[CUSTOMER][POSITIVE] OK, all right, that's what I needed thank you so much for your help.
[AGENT][POSITIVE] You're welcome. Well, thank you for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you, bye bye.