AccountId: 011433970860
ContactId: 95fff445-ab24-4369-8d6c-84e2fe4c7610
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 247699 ms
Total Talk Time (AGENT): 125645 ms
Total Talk Time (CUSTOMER): 82011 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/95fff445-ab24-4369-8d6c-84e2fe4c7610_20250411T20:19_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, yes, uh, my name is [PII]. I'm calling from a dental office. What information do you need from me first?
[AGENT][NEUTRAL] OK, Ms. [PII], let me have a uh callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, and what's the name of the facility?
[CUSTOMER][NEUTRAL] A, a healthy small dental or it could be under Doctor uh [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it is bear with me two seconds. I just had it 090 I'm sorry 01963818.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] All right, and what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, it is [PII], uh [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you. And you need uh this benefit information given to you verbally or faxed over to you?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, probably fine.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, and let's see.
[AGENT][NEUTRAL] Before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. Um, so we have a calendar year maximum of 1500 per cover insured.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEGATIVE] With the $50 deductible and deductible does not apply to preventative expense.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Preventative is cover 100%.
[AGENT][NEUTRAL] Radiograph FMXs cover 80%, basic expense and basic restorative expenses cover 80%.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] A major service including endodontics, periodontics, proonic repair, and oral surgery, they're all 40% after the 12 month waiting period, which she's already out of the waiting period, or he is already out of the waiting period.
[CUSTOMER][POSITIVE] Got it, got it perfect.
[AGENT][NEUTRAL] Um, OK. And do any frequencies?
[CUSTOMER][NEUTRAL] Uh, only for the 4910 if it's just frequency with the profi.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] I don't believe so, but let me double check. No, it doesn't share frequency.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] It's not OK. And how many, uh, does he get to have in a year or calendar per se?
[AGENT][NEUTRAL] Um, it's once every 6 months.
[CUSTOMER][NEUTRAL] Oh, OK, so, uh, it doesn't share frequency with uh with the profi, so it's 6 months period or 6 months of, uh, pro fee.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, got it. OK, perfect. OK, awesome, um, that is all I needed for today. I do appreciate your help.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Oh, actually, you know what last question I'm sorry, um, does the patient have coverage for the 1208?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 1208.
[AGENT][NEUTRAL] OK, so that's gonna be for um
[AGENT][NEUTRAL] Fluoride.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] That's the fluoride, correct?
[CUSTOMER][POSITIVE] Yes, that is correct.
[AGENT][NEUTRAL] Yeah, that is covered under uh preventative.
[CUSTOMER][NEUTRAL] It is OK for his age as well?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, yeah, it's gonna be, let me see, let me look at it, limitations of the policy. All right, so this is going to be.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't let's see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Maximum limited to the children, dependent children under the age of [PII].
[CUSTOMER][POSITIVE] Oh OK, got it, got it. OK, perfect. Other than that, that is literally all I needed for today. I do appreciate your help.
[AGENT][NEUTRAL] Mhm, yeah.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day. Good afternoon, Ms. [PII].
[CUSTOMER][POSITIVE] Likewise, thank you for him.
[AGENT][POSITIVE] You're welcome. Bye.