AccountId: 011433970860
ContactId: 94a7d23b-67a5-423e-8458-2de50521349b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 339010 ms
Total Talk Time (AGENT): 142097 ms
Total Talk Time (CUSTOMER): 89984 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/94a7d23b-67a5-423e-8458-2de50521349b_20250507T15:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I'm calling from the rental office for dental eligibility and benefits on a recorded line. Could you please help me with that?
[AGENT][NEUTRAL] OK. I can. And you said that you're calling from a doctor's office or a hospital setting?
[CUSTOMER][NEUTRAL] Provide its office.
[AGENT][NEUTRAL] OK. And what's the policy number?
[CUSTOMER][NEUTRAL] It's 02559646.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII]? OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], uh [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] 02559646. Mhm.
[AGENT][NEGATIVE] Yeah, I typed it in incorrectly.
[AGENT][NEUTRAL] So for [PII], I'm showing an effective date of [PII]. The policy is active at this time and you did say that her date of birth is [PII]?
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] OK, now this is a dental policy. Are you a medical provider's office?
[CUSTOMER][NEUTRAL] Dental, dental.
[AGENT][NEUTRAL] Oh, you're dental. OK. Do you want the schedule faxed over to you?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] If you could provide me verbally over the phone just for this one patient.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How about their group name and number?
[AGENT][NEUTRAL] One moment. Now, if you're wanting to go through a bunch of codes, I'm gonna have to submit the fax over to you because it's about 4 pages.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Let's see, I show the group number to be 70,030.
[AGENT][NEUTRAL] And the name is Creative Circle.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And is there any missing to clause or wait period?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Is there any missing clot or waiting period?
[AGENT][NEUTRAL] There is a missing tooth clause. There's no waiting period. This policy covers preventive and basic only. Major is not covered.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm. And also, uh, for the, could you also provide me the max and deductibles?
[AGENT][NEUTRAL] It's a $500 calendar year max, a $50 deductible.
[CUSTOMER][NEUTRAL] It's uh 50, there's no family deductible?
[AGENT][NEUTRAL] It's up to 150.
[CUSTOMER][NEUTRAL] OK. And no auto coverage.
[AGENT][NEUTRAL] And she's the only one on the plan. What was your next question?
[CUSTOMER][NEUTRAL] There's no auto coverage.
[AGENT][NEUTRAL] There's orthodontic services are not covered, implants are not covered.
[AGENT][NEUTRAL] It covers preventive and basic only.
[CUSTOMER][NEUTRAL] OK. And actually, I just have a 5 to 65 code if you could help me out.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I just have 56 post codes.
[AGENT][NEUTRAL] Did you say 5 procedure codes?
[CUSTOMER][NEUTRAL] Yes, 56.
[AGENT][NEUTRAL] And what are they?
[CUSTOMER][NEUTRAL] It's uh 0120.
[CUSTOMER][NEUTRAL] 0 to 10.
[CUSTOMER][NEUTRAL] 0274.
[CUSTOMER][NEUTRAL] 106208 and 0330.
[AGENT][NEUTRAL] And what information did you need with these codes?
[CUSTOMER][NEGATIVE] Just the cons and frequencies.
[AGENT][NEUTRAL] OK, so basic is paid at 80%. Preventive is paid at 100%. Other frequencies for the cleaning is once every 6 months.
[AGENT][NEUTRAL] For the full mouth, X-ray and pano, it's once every 5 years.
[AGENT][NEUTRAL] Any bite wing X-rays, it's once per twelve-month period.
[AGENT][NEUTRAL] And for oral evaluations it's 2 for 12 month period.
[CUSTOMER][NEUTRAL] How about fluoride.
[AGENT][NEUTRAL] You know, that's under the cleaning, which is once every 6 months.
[CUSTOMER][NEUTRAL] There's no age limit.
[AGENT][NEUTRAL] Uh, there is one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's um for dependent children aged [PII].
[CUSTOMER][NEUTRAL] And feelings, is it once in 6 months also?
[AGENT][NEUTRAL] It limit
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, one procedure per 36 months.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Same age limit [PII].
[AGENT][NEUTRAL] 11 moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Limited dependent children under the age of [PII].
[AGENT][NEUTRAL] Uh, application made to permanent molar teeth only.
[CUSTOMER][NEUTRAL] And so there's nothing, nothing that, right?
[AGENT][NEUTRAL] She doesn't have any claims on file so that would be correct.
[CUSTOMER][POSITIVE] OK. So that'll be it, um, [PII]. Thank you very much and you have a wonderful day.
[AGENT][NEUTRAL] And you're welcome and anything provided today, any information provided today is verification, only not a guarantee of payment, [PII], and thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye bye.