AccountId: 011433970860
ContactId: ae773ffa-5c7a-4254-8604-bf594f0666d9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 231720 ms
Total Talk Time (AGENT): 74035 ms
Total Talk Time (CUSTOMER): 110472 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/ae773ffa-5c7a-4254-8604-bf594f0666d9_20250619T20:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII] and I work in Doctor [PII]'s office, and I am trying to verify some insurance pretty please.
[AGENT][NEUTRAL] OK, [PII], I can help you with eligibility and benefits if you need those. Um, what's your good callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mine is [PII].
[AGENT][NEUTRAL] OK, thank you. And what's the policy number for that patient?
[CUSTOMER][NEUTRAL] Um, let me look right here.
[CUSTOMER][NEUTRAL] It looks like 02465258 and I also have a group number.
[AGENT][NEUTRAL] OK. And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is gonna be [PII], date of birth.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Looks like she is coming in to get her wisdom teeth out on Monday and I'm trying to check eligibility and see if there's any coverage on sedation or extraction of wisdom teeth.
[AGENT][NEUTRAL] OK. Uh, it looks like her policy is effective [PII].
[AGENT][NEUTRAL] And let me pull
[CUSTOMER][NEUTRAL] Alright, hold on
[CUSTOMER][NEUTRAL] All right, got it. I guess it's under her dad [PII]. I don't have his date of birth. I'm so sorry, but.
[AGENT][POSITIVE] Uh, yes, looks like that's correct. Um, let me pull up the benefits real quick.
[CUSTOMER][NEUTRAL] Hi.
[CUSTOMER][POSITIVE] I can give you procedure codes whatever you need.
[AGENT][NEUTRAL] OK. And uh what is the procedure code?
[CUSTOMER][NEUTRAL] Um, first one is D 9222.
[AGENT][NEUTRAL] Um, I don't show that covered.
[CUSTOMER][NEUTRAL] That's not covered. How about D9223?
[AGENT][NEUTRAL] I don't show that either.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um, how about D7240?
[AGENT][NEUTRAL] Uh, yes, that is covered, um, not a guarantee of payment, basic outline of the policy. It's under oral surgery, and for this policy,
[AGENT][NEUTRAL] Oral surgery pays 40% after a um $50 deductible is met.
[AGENT][NEUTRAL] Calendar year max is 1500.
[CUSTOMER][NEUTRAL] It's
[AGENT][NEUTRAL] And they do have a 12 month waiting period, which looks like that's been satisfied because the effective dates for [PII] so.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and then actually I've got.
[CUSTOMER][NEUTRAL] Teeth numbers 1 1617 and 32 at D 7240 so that's gonna be covered.
[CUSTOMER][NEUTRAL] At 40% right.
[CUSTOMER][NEUTRAL] Let me see if I need anything.
[CUSTOMER][NEUTRAL] Out and you said 1500 and then.
[CUSTOMER][NEUTRAL] Deductible $50 right.
[AGENT][NEUTRAL] And then I can send a fax back if you need that or if you're interested, that does have everything for the policy for your records or or not so.
[CUSTOMER][POSITIVE] That would be wonderful. Do you mind faxing that 256?
[CUSTOMER][NEUTRAL] 429.
[CUSTOMER][NEUTRAL] 341 3.
[AGENT][NEUTRAL] OK, that was [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] OK. Yes, I'll get that faxed your way. Just give me a few minutes. And is there anything else I can help with today, [PII]?
[CUSTOMER][POSITIVE] Ma'am, I appreciate your help.
[AGENT][POSITIVE] OK, thank you for calling APL. Have a great afternoon.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye.