AccountId: 011433970860
ContactId: a9375654-bc6b-4837-bfb4-18f737b3f938
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 306010 ms
Total Talk Time (AGENT): 63170 ms
Total Talk Time (CUSTOMER): 194000 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/a9375654-bc6b-4837-bfb4-18f737b3f938_20250327T18:36_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] [PII] to see out of it.
[CUSTOMER][NEUTRAL] Hi, yeah, this is [PII] over at Family Dental Care. Um, I'm calling, uh, for hopefully information on a patient we have.
[AGENT][POSITIVE] I'll be happy to assist.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes, I would like to check their eligibility and then a couple of procedure codes.
[AGENT][NEUTRAL] May I have the policy number please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, give me one second, sorry.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] I'm also this this person has not been a they have not come in since [PII], so there's a possibility they are not currently with the same insurance company. I'm not 100%, but I can give you this number that we have on file.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, it is uh 9559 wait nope nope nope nope sorry I just clicked on the wrong name 100% here we go let me restart.
[CUSTOMER][POSITIVE] Sorry about that.
[CUSTOMER][NEUTRAL] OK, here we go, um, I have 02287075.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] I have a [PII] and date of birth is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Cool.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, I have [PII] on [PII].
[AGENT][NEUTRAL] And I will have to fax over the codes for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, could you just to confirm, the, the max is, is supposed to be the or the like the coverage max is supposed to be $500 is that correct still? Or do you, OK, and OK, cool, um, do you need those codes?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, they will have to be faxed over. What's the fax number?
[CUSTOMER][NEUTRAL] Oh, OK, sure.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 30 or what do you need the 10 digit?
[AGENT][NEUTRAL] Yeah, your fax number.
[CUSTOMER][NEUTRAL] [PII]. It should drop the you.
[AGENT][NEUTRAL] OK, now the codes aren't for major services are they?
[CUSTOMER][NEUTRAL] No, they are all um preventative.
[CUSTOMER][NEUTRAL] I believe there might be one basic but not 100%.
[AGENT][NEUTRAL] What's the code?
[CUSTOMER][NEUTRAL] Um, can we do D0120?
[CUSTOMER][NEUTRAL] Um, and then we.
[AGENT][NEUTRAL] That's um
[AGENT][NEUTRAL] That's under preventative.
[AGENT][NEUTRAL] So that would be covered at 100%.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I guess the only thing I would need to check is if they have had the um, sorry, hold on, trying to look at things that are in files and whatnot um I'm seeing.
[CUSTOMER][NEUTRAL] From what we have on file that there's a once per 12 month period on the bite wing services, the uh what is the D 0274 right um.
[CUSTOMER][NEUTRAL] Just trying to see, I don't know if you have on file if they had if this patient had that done the last time they were here or when the last time they've had that done is.
[AGENT][NEUTRAL] I'm sure they had bite Wings [PII].
[CUSTOMER][NEUTRAL] [PII] 20, OK, OK, so assuming that's still the one for 12 months they would be ineligible for that, right?
[AGENT][NEUTRAL] Until after [PII], yes.
[CUSTOMER][NEUTRAL] OK, um, and then do you guys did the, the, um, does it cover the fluoride, the D 1208?
[AGENT][NEUTRAL] That's not on the list, only.
[AGENT][NEUTRAL] 12011203 1204 and 1205.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So if the code is not on the fax back it that means it's not covered.
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][POSITIVE] I see, I see, OK, um, OK, then that should be everything. I, um, I appreciate the help.
[AGENT][NEUTRAL] Was there anything else I can assist with today?
[CUSTOMER][NEUTRAL] Um, I don't think is that is that fax coming through or um.
[AGENT][NEUTRAL] You should receive it within 10 minutes.
[CUSTOMER][POSITIVE] OK, sweet, perfect um yeah that should be it then.
[AGENT][POSITIVE] Alright, thank you for calling APL. You have a good day.
[CUSTOMER][POSITIVE] Alright, I can help.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][NEUTRAL] Mhm. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.