AccountId: 011433970860
ContactId: a987db37-ed86-43f4-a8fd-237dd0d0fe71
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 446480 ms
Total Talk Time (AGENT): 133313 ms
Total Talk Time (CUSTOMER): 243070 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/2025/02/07/a987db37-ed86-43f4-a8fd-237dd0d0fe71_20250207T16:02_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] calling on behalf of the provider's office. Can you please help me verifying dental benefits for a patient today?
[AGENT][POSITIVE] I'd be happy to assist with benefits today [PII] if I can get a good call back number for you.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes, callback number I have here is [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Policy number, yes. Um, I have here.
[CUSTOMER][NEUTRAL] Um 01997266.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment.
[AGENT][NEUTRAL] I do show the policy is currently active. Effective date is [PII].
[AGENT][NEUTRAL] And are you calling, um, I'm sorry, are you needing a fax back breakdown of the benefits?
[CUSTOMER][NEUTRAL] [PII], will you be able to help me verbally?
[AGENT][NEUTRAL] Uh, the only thing we wouldn't give verbally is coding and frequency, but anything else can be given verbally.
[CUSTOMER][NEUTRAL] OK, um, so, um, in the fax bag will I get the codes?
[AGENT][NEUTRAL] That's correct and if you don't see a code on the fax back, that means it's not covered.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] It's not covered? OK, thank you so much. And is there any providers participation for this plan?
[AGENT][NEUTRAL] Um, with this policy we don't have a network, so, um, the patient can see any provider that they choose.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] OK, thank you. The coordination of benefits fully the standard or non duplicate thing.
[AGENT][NEUTRAL] I'm sorry, repeat that for me.
[CUSTOMER][NEUTRAL] The coordination of benefits, will it be standard or?
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Standard.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Standard, is there any timely filing limit for claims?
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] No filing limit um group name and group number please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Group number is 13611.
[AGENT][NEUTRAL] And group name is Universal Trucking.
[CUSTOMER][NEUTRAL] Universal?
[AGENT][NEUTRAL] Yes, Universal Trucking.
[CUSTOMER][NEUTRAL] Oh, and I'm so sorry, uh, the second word one more time, Universal.
[AGENT][NEUTRAL] Trucking, T R U C K I N G Trucking.
[CUSTOMER][NEUTRAL] Trucking, oh.
[CUSTOMER][POSITIVE] Got it. Thank you. Any missing too close waiting period?
[AGENT][NEUTRAL] Um, yes, there's a missing tooth cloth and the waiting period has been already, um, met since their policy was, um, back in [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Any downgrades on crowns and posterior composites?
[AGENT][NEUTRAL] We don't do downgrades.
[CUSTOMER][NEUTRAL] Mm, no downgrade. Are we allowed to perform all the 4 cards on the same day for the SRP?
[AGENT][NEUTRAL] I'm sorry, repeat that.
[CUSTOMER][NEUTRAL] Um, yes, can we perform all the four quotes on the same day for SRP, the scaling and with planning.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, OK, um, major services are paid.
[CUSTOMER][NEUTRAL] On sea date or date?
[AGENT][NEUTRAL] Set.
[CUSTOMER][NEUTRAL] It did
[CUSTOMER][NEUTRAL] For surgical extraction, do we pay on the dental or medical first?
[AGENT][NEUTRAL] Um, repeat that.
[CUSTOMER][NEUTRAL] For surgical extractions, uh, do we pay under dental or medical first?
[AGENT][NEUTRAL] Medical.
[CUSTOMER][POSITIVE] Oh, medical, thank you.
[CUSTOMER][NEUTRAL] And the annual max and the deductibles, please.
[AGENT][NEUTRAL] Annual max is $1500 and deductible is $50.
[CUSTOMER][NEUTRAL] $1550 and any family deductible?
[AGENT][NEUTRAL] Um, 150.
[CUSTOMER][NEUTRAL] 150. And the deductible, will it apply on preventative services?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Mm, no, deductible doesn't apply on the max, will it, OK. Uh, and the max, will it apply on preventative?
[AGENT][NEUTRAL] Only basic I mean.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] It does. OK.
[CUSTOMER][NEUTRAL] Thank you. And also, is there any auto coverage?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No orthodontics. Thank you. And any history on file for this patient that might affect the frequency for the current year?
[AGENT][NEUTRAL] Uh, let me check.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Yeah, he had a panel on [PII].
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] So just the panel because it's been more than 6 months for the.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And then bite the white wings.
[CUSTOMER][NEUTRAL] Um, by twins on the same date?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, [PII]. OK, thank you so much and I also wanted to ask, um, will I get the age limitations as well for the floor ceilings on the flags back?
[AGENT][NEUTRAL] Yes, the, um, exclusion, um, that, that's also on the fax back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you and just, uh, can you also just provide me the insurance please that for preventive basic and major.
[AGENT][NEUTRAL] Preventive is 100%, basic is 80, major is 40.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 18,040. OK. 18,040. Thank you so much. And can you also provide me the mailing address and the payer ID please?
[AGENT][NEUTRAL] OK, that'll be on the fax back as well.
[CUSTOMER][NEUTRAL] On the side side. OK, thank you so much. And will you be able to check if there's any secondary insurance for this patient's plan apart from um this plan?
[AGENT][NEUTRAL] We don't have that information. You'll have to get that from the insured.
[CUSTOMER][NEUTRAL] OK, and uh just one more question here, sorry, um, the, the periodontal maintenance will it share its frequency with the pro the 4910, will it share with the profy?
[AGENT][NEUTRAL] Um, that you'll have to get on the fax, but we don't do that verbally. That's considered coding and frequency.
[CUSTOMER][NEUTRAL] Oh, OK, sure.
[CUSTOMER][NEUTRAL] OK, sure, sure, no problem. Thank you so much, [PII] and the call reference number, please. Oh no, can you, yeah, the fax number I have it here. If you can kindly send me the fax.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] Um, it is [PII].
[CUSTOMER][NEUTRAL] And how long does it take uh for the fax?
[AGENT][NEUTRAL] Between 7 and 10 minutes.
[CUSTOMER][POSITIVE] OK sure thank you so much.
[AGENT][NEUTRAL] Was there anything else I could assist with today?
[CUSTOMER][POSITIVE] No, that would be all. Thank you so much and just a reference number please.
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Once again, you have a great rest of your day. Thank you.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye bye.