AccountId: 011433970860
ContactId: 942607b7-6ecb-4e29-9831-d073046b0b08
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217130 ms
Total Talk Time (AGENT): 63943 ms
Total Talk Time (CUSTOMER): 112545 ms
Interruptions: 1
Overall Sentiment: AGENT=1.8, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/942607b7-6ecb-4e29-9831-d073046b0b08_20250214T18:47_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from the dentistry. Um, I was calling because I was trying to verify benefits for one of our patients.
[AGENT][POSITIVE] OK, I'd be happy to assist with benefits.
[AGENT][POSITIVE] If I can get a good call back number for you?
[CUSTOMER][NEUTRAL] Sure, it'll be [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I have 02479064.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, patient's gonna be [PII]. Her date of birth is [PII].
[AGENT][POSITIVE] Thank you for that information.
[AGENT][NEUTRAL] Please be advised that verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII]. And were you needing a fax back breakdown of the benefits?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] As well
[AGENT][NEUTRAL] And what is that fax number?
[CUSTOMER][NEUTRAL] My fax number is gonna be 1 2nd.
[CUSTOMER][NEUTRAL] That is uh it's [PII].
[AGENT][NEUTRAL] Alright, you should receive that fax in the next 5 to 7 minutes. Was there anything else I can assist with today?
[CUSTOMER][POSITIVE] Perfect
[CUSTOMER][NEUTRAL] Uh, yes, ma'am. Can you tell me a couple of things that probably won't be on the facts, um, if there's a waiting period or a missing tooth cloth on the policy?
[AGENT][NEUTRAL] Um, yes, there is a waiting period. Waiting period will be up on [PII] of this year, and there is a missing tooth cloth.
[CUSTOMER][NEUTRAL] OK, so the cost does apply. The waiting period would it apply on all services, or would it be just on basic and major?
[AGENT][NEUTRAL] Just on major
[CUSTOMER][POSITIVE] Major awesome. OK, uh, and as far as the fee schedule goes, who do y'all follow as far as fee schedule or would it be like a UCR fees?
[AGENT][NEUTRAL] UCR.
[CUSTOMER][POSITIVE] UCR awesome and payment does come to the provider right as long as there's signature on file?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Perfect, um, do all exempt, would all exempt share frequencies?
[AGENT][NEUTRAL] Um, no, the frequencies are on the.
[AGENT][NEUTRAL] Fax back.
[CUSTOMER][NEUTRAL] Got it. So, but it would tell me like if a limited exempt shares the same frequency as a 0 120, or it would have, OK, awesome. Uh, do you, does the policy will they tell me on the downgrades if you downgrade?
[AGENT][POSITIVE] That's correct. That's correct. Mhm.
[AGENT][NEUTRAL] We don't do downgrades.
[CUSTOMER][POSITIVE] No downgrades, perfect. Do you pay on seat or per day?
[AGENT][NEUTRAL] See
[CUSTOMER][NEUTRAL] Seat, uh, on the SRPs, are all 4 calls allowed to be done on the same day?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and do you have a healing period afterwards before we can do a per maintenance?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No. OK. And then do you require medical EUB for any of the oral surgeries?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, OK, perfect, uh, and then any history on file for this patient?
[AGENT][NEUTRAL] Uh, let me check.
[CUSTOMER][NEGATIVE] sorry.
[AGENT][NEUTRAL] No, no history.
[CUSTOMER][POSITIVE] Awesome and this policy would run on the calendar year, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] Perfect. Alright, thank you so much and I will wait on the fax back.
[AGENT][NEUTRAL] OK, was there anything else I could assist with today?
[CUSTOMER][POSITIVE] Uh, no, that was all thank you.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.