AccountId: 011433970860
ContactId: 9f290dd6-e7ae-46ed-85e3-9d4df13522d4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 317220 ms
Total Talk Time (AGENT): 142779 ms
Total Talk Time (CUSTOMER): 152591 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/9f290dd6-e7ae-46ed-85e3-9d4df13522d4_20250210T18:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], uh, my name's [PII]. I'm calling from Doctor [PII]'s office at Dogwood Dental, and I'm trying to check on a patient who's here. I'm trying to check on her benefits, please.
[AGENT][POSITIVE] OK, OK, yeah, I'm happy to check on benefits and eligibility. Do we have their policy number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, um, it is 02592825.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Pull that up here one moment.
[AGENT][NEUTRAL] And if I could get the patient name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII] and her birthday is [PII].
[AGENT][NEUTRAL] Thank you. So the patient is active. Uh, it looks like the effective date is going to be [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we can also send a fax back with a breakdown of benefits too if you need to.
[CUSTOMER][NEUTRAL] Yeah, I requested one. I just spoke with someone and I requested one I just hadn't received it and I'm I'm just trying to help her out and she, she's needing um a filling the code is uh D2332.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] something.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] What the $500 is, uh, no, but I'll ask her, yeah.
[AGENT][NEUTRAL] 2332.
[CUSTOMER][NEUTRAL] And you
[AGENT][NEUTRAL] OK, so it looks like 2332 is covered. It's showing 80% of allowable.
[AGENT][NEUTRAL] The plan pays by UCR and then let me see what the limit, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] I'm sorry, can you, can you repeat that? You said 80% allowable?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the plan pays by UCR usual customary fee.
[AGENT][NEUTRAL] And it looks like.
[CUSTOMER][NEUTRAL] You said the plan pays by UC what was that?
[AGENT][NEUTRAL] UCR
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it looks like the limitations on that.
[AGENT][NEUTRAL] are a maximum of 1 each tooth for 24 months.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can only replace the existing in place for 24 months.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then did you need to see if they've used anything?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Um, yeah, that would be great.
[AGENT][POSITIVE] Yeah, absolutely. Let me take a look.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] She, she did have a question, um, she was wondering, she knew about $500 that had been mentioned maybe through her employer and she didn't know is there an amount um that they provide like I don't know if it's an HSA or or do you know anything about um a $500 amount?
[AGENT][NEUTRAL] That like the company is paying towards like uh coverage or like usage or something like that?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'm, I'm not sure, um, she just remembered that $500 was mentioned. I think she thought it was probably towards like her benefits to be able to use, um, so I.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] I didn't know.
[AGENT][NEUTRAL] Yeah, I mean the only thing that I am aware of is just, you know, that that's the calendar year maximum, um, I don't have yeah any information if her employer gives some sort of allowable amount that they pay towards services, we wouldn't have that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so the $500 is the calendar year maximum that the plan has.
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] And she still has that full amount, and then there is a $50 deductible which she has left, uh, yet still to me also.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, that is wonderful thank you um so I think that will at least get us started here for her and so we can get her out of pain, um, and then I will just wait on that fax back to fix the rest of of our information because we have I think we have some numbers off on our system. OK, well thank you so much for your help.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And
[AGENT][POSITIVE] You're welcome. Have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye bye.