AccountId: 011433970860
ContactId: 982b40c3-df41-4139-9247-e2cb025e65f1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223279 ms
Total Talk Time (AGENT): 106875 ms
Total Talk Time (CUSTOMER): 107050 ms
Interruptions: 1
Overall Sentiment: AGENT=1.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/982b40c3-df41-4139-9247-e2cb025e65f1_20250110T21:40_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. My name is [PII].
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling on behalf of the dental office to check the eligibility for a member. Could you please help me with that?
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with eligibility for dental benefits. What is the callback number?
[CUSTOMER][NEUTRAL] Sure, callback number is [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Thank you. And what is the policy number?
[CUSTOMER][NEUTRAL] Sure, policy number is going to be.
[CUSTOMER][NEUTRAL] 02554265
[AGENT][NEUTRAL] And the patient's name and date of birth, please, sir?
[CUSTOMER][NEUTRAL] Patient name is [PII] with the date of birth of [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][POSITIVE] And [PII], it would be my pleasure to assist you with that dental eligibility. I am showing that her policy is active.
[AGENT][NEUTRAL] Effective date is [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And anything else I can help you with?
[CUSTOMER][NEUTRAL] Um, I'm not
[CUSTOMER][NEUTRAL] So I'm having a few questions like the frequency for this member plan. Could you please help me with that, like the preventative services frequency.
[AGENT][POSITIVE] Sure, it would be my pleasure. Now, also, I do have a breakdown. I can fax to you with all the policy information if you are interested.
[CUSTOMER][NEUTRAL] I think so. I previously asked for the facts and the rep.
[CUSTOMER][NEGATIVE] Sending me the, send the fax to me but I am not able to receive the fax. I don't know why, so it would be great if you give me the frequency, just the frequency with the call to me.
[AGENT][POSITIVE] Sure, sure, it would be my pleasure. And [PII], I'm showing that for Provis uh it is once every 6 months.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Or oral evaluation is 2 for 12 month period.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bite wings for once per 12 month period.
[AGENT][NEUTRAL] And FMX and panel is once every 5 years. And major procedures are not covered under this plan. It includes oral surgery, endodontic services, periodontic services, and prosthodontic repairs.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, great. I, I know that information previously, uh, rep, uh, gave me those information. I want to know about P maintenance. Is it covered?
[AGENT][POSITIVE] Good.
[AGENT][NEGATIVE] It is not. Any of your periodontal services are not covered.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. And what about fluoroid?
[AGENT][NEUTRAL] Fluoride is under the age of [PII] and that is.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let me get that for you. Bear with me just.
[CUSTOMER][NEUTRAL] On the way, so I don't need that. I think so the patient won't be eligible, right?
[AGENT][NEUTRAL] It is 10 minutes.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] And uh one last code that is 0431.
[AGENT][NEGATIVE] Yes, she's not eligible.
[CUSTOMER][NEUTRAL] Is it covered?
[AGENT][NEUTRAL] 0431.
[CUSTOMER][NEUTRAL] Yup.
[AGENT][NEUTRAL] Let me check that for you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] I do not see 0431 listed, so it's not covered.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][POSITIVE] Oh, OK, amazing, thank you for the information and could you please help me with your name, by the way?
[AGENT][POSITIVE] Sure. My name is [PII], it was a pleasure to assist you with that eligibility. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] All right, I
[CUSTOMER][POSITIVE] No further you're done with the questions and thank you for the information you provided and thank you for your help, by the way.
[AGENT][POSITIVE] My pleasure. You have a wonderful afternoon and a happy weekend.
[CUSTOMER][POSITIVE] You do as well bye bye take care.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah.