AccountId: 011433970860
ContactId: 9d194712-fd6b-4d06-a68c-a9476398e852
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 408940 ms
Total Talk Time (AGENT): 125143 ms
Total Talk Time (CUSTOMER): 153214 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/9d194712-fd6b-4d06-a68c-a9476398e852_20250106T16:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. This is [PII]. I'm calling on behalf of the provider's office for this patient here. I do have a few questions to verify, so please help me with that.
[AGENT][NEUTRAL] And spell your name for me?
[CUSTOMER][NEUTRAL] Oh yeah, that is [PII]
[AGENT][NEUTRAL] Give me that again.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Spell your name for me again please.
[CUSTOMER][NEUTRAL] Oh, sure. It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Oh [PII], OK, and I'm sorry, how can I help you today, [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh yeah, please help me with a few questions that I have here for this patient, please.
[AGENT][NEUTRAL] Regarding a claim?
[CUSTOMER][NEUTRAL] No, no, no, eligibility and benefits.
[AGENT][NEUTRAL] OK, and so for what type of service in a doctor's office?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, and what's the policy number?
[CUSTOMER][NEUTRAL] 018361113.
[AGENT][NEUTRAL] 018361113
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's a good call back number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. That is [PII].
[AGENT][NEUTRAL] Thank you, the patient's name and date of birth?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Patient's name I have here is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you for that information, [PII].
[CUSTOMER][POSITIVE] You're welcome. You're welcome.
[AGENT][NEUTRAL] So I'm showing an effective date of [PII], the policy is active at this time, and I have, are you a dental provider?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, would you like to schedule a benefits faxed over to you?
[CUSTOMER][NEUTRAL] Uh, no, actually, I only have a few questions for the patient. So yeah, if you don't mind, could you please help me verify here for the FMX and panoramics? May I know if they are sharing the same frequencies or not?
[AGENT][NEUTRAL] You said pano and FMX?
[CUSTOMER][POSITIVE] Ethic. Yes, that's correct.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] Oh, sure, no problem.
[AGENT][NEUTRAL] And give me the procedure codes for the 2 items.
[CUSTOMER][NEUTRAL] Oh sure, no problem. For the next I have here is 0210. And for panoramics is 0330.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so they do share frequencies and they're entitled to one procedure in any uh per 5 year period.
[CUSTOMER][NEUTRAL] OK, got that. Thank you very much. And uh can you please help me here once again for the deductible? May I know if it's only applies to the major and major and basic services only?
[AGENT][NEUTRAL] Major and basic.
[CUSTOMER][NEUTRAL] OK, got that. Thank you very much. And is there any history on file for this patient that might affect the frequencies?
[AGENT][NEUTRAL] Regarding these two codes that you gave me?
[CUSTOMER][NEUTRAL] No, no, no, no. Like all of the uh
[CUSTOMER][NEUTRAL] Procedure codes here. OK. If you don't mind, shall I proceed with the
[AGENT][NEUTRAL] OK, they have a they have a plethora of a history. So are there any specific codes you mean like the cleanings?
[CUSTOMER][NEUTRAL] Oh yes. Mhm, yes. OK, let me just.
[AGENT][NEUTRAL] The preventive services?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][POSITIVE] Mhm. Sure, no problem.
[AGENT][NEUTRAL] OK, so I'm showing a pro fee and then a comprehensive or eval, so that's the D11110 and the 0150. That was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] A Profi is once every 6 months.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the exams are 2 per 12 month period.
[CUSTOMER][POSITIVE] Mhm. OK, got that. Thank you very much.
[AGENT][NEUTRAL] So there was those on [PII] still looking?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I'm showing another pro fee on [PII].
[AGENT][NEUTRAL] And a periodic oral exam on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] That's all I'm showing they had a limited or bowel in 22.
[CUSTOMER][NEUTRAL] OK, thank you very much. And uh may I know here for SRP and perio maintenance as well in case if they are having uh any history on file?
[AGENT][NEUTRAL] Can you give me the codes.
[CUSTOMER][NEUTRAL] Oh, sure. 4341 and 4910.
[AGENT][NEUTRAL] 1341 and then 4910.
[CUSTOMER][NEUTRAL] 4341 and 4910, yes.
[AGENT][NEUTRAL] OK. Did you have any other codes?
[CUSTOMER][NEGATIVE] Uh, no.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm not showing history of the 4341 and the 4910.
[CUSTOMER][NEUTRAL] OK, thank you very much. And lastly, uh, just to confirm, the fees scheduled for this one is UCR, is it correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And the group number is 15,210.
[AGENT][POSITIVE] Right, that is correct.
[CUSTOMER][POSITIVE] OK, OK, thank you very much for all the information. different parts to me I really appreciate that and I hope you have a great day ahead. Thank you so much and bye-bye for now. Take care.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You're welcome, [PII]. Thanks for calling APL and did you just call a minute ago today?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Did you you call today? OK.
[CUSTOMER][POSITIVE] Yes, I did, yes.
[AGENT][POSITIVE] OK. All right. Well, thank you. Have a good day.
[CUSTOMER][POSITIVE] You're welcome. You too, bye bye.