AccountId: 011433970860
ContactId: aae8474b-638a-473d-a4d6-b9b176b37b14
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 300059 ms
Total Talk Time (AGENT): 114591 ms
Total Talk Time (CUSTOMER): 85194 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/aae8474b-638a-473d-a4d6-b9b176b37b14_20250321T16:32_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is, uh, on behalf of the dental office to check the patient eligibility and dental benefits on a recorded line.
[AGENT][NEUTRAL] OK. And what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you have a callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 02598171.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[CUSTOMER][POSITIVE] Sure, [PII], take your time.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] Patient is uh [PII] call, [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you were calling about benefits?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can help you with that. The effective date is [PII]. Any benefits given over the phone is not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] They have a $500 calendar maximum.
[AGENT][NEUTRAL] $50 deductible on everything except for preventative.
[CUSTOMER][NEUTRAL] Uh, my, uh, could you please help me with the reschedule? The provider is in network or out of network?
[AGENT][NEUTRAL] We do not have that information. We use Carrington's network, so it would depend on um if you all are Carrington provider.
[CUSTOMER][NEUTRAL] OK, first of all, uh, [PII], help me with the group name and the number.
[AGENT][NEUTRAL] 70087.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Partners
[AGENT][NEUTRAL] Personnel.
[AGENT][NEUTRAL] Management services.
[CUSTOMER][POSITIVE] Wonderful.
[CUSTOMER][NEUTRAL] Now proceed with the benefits.
[AGENT][NEUTRAL] Preventative is paid at 100% of usual and customary rate.
[AGENT][NEUTRAL] Basic is paid at 80%.
[AGENT][NEUTRAL] This policy does not cover major work. So indo Pero.
[AGENT][NEUTRAL] Or surgery?
[AGENT][NEUTRAL] Crowns, bridges, partials, dentures, implants, ortho is not covered.
[CUSTOMER][POSITIVE] And thank you.
[CUSTOMER][POSITIVE] OK, wonderful. Help me with the uh deductible, anything has been used from the maximum.
[AGENT][NEUTRAL] Hold on just a moment, I'll check.
[AGENT][NEUTRAL] She has no history, so she has not met the deductible using any of the maximum.
[CUSTOMER][NEUTRAL] And the deductible is $50 for individual.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That is no waiting period no missing the clause, right?
[AGENT][NEGATIVE] It doesn't apply. Majors not covered.
[CUSTOMER][POSITIVE] Wonderful. So, help me with the frequencies.
[AGENT][NEUTRAL] All exams are 2 for 12 months?
[AGENT][NEUTRAL] Trophies or once every 6 months.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Bite wings or once in 12 months?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Fillings are 1 in 24 months, we do not downgrade on anything.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what else were you needing?
[CUSTOMER][NEUTRAL] Uh, FMX and uh fluoride.
[AGENT][NEGATIVE] Fluoride's not covered. Um.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] The full mile pin and the code [PII] are all combined.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And it's 1 in 5 years.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Excellent, [PII]. uh and uh.
[CUSTOMER][NEUTRAL] Nothing else, nothing, no history as well, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, perfect. And then my questions for this patient. Uh, do you have any call reference number for today's call?
[AGENT][NEUTRAL] We do not have call reference numbers. You can use my name and today's date.
[CUSTOMER][POSITIVE] OK. Excellent. I'm no no questions for this patient and thank you for your help.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day.
[CUSTOMER][POSITIVE] You too, [PII]. Take care. Bye-bye.
[AGENT][POSITIVE] Thank you.