AccountId: 011433970860
ContactId: b3d26b8c-7071-4697-9eb7-c598352a05bd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 507380 ms
Total Talk Time (AGENT): 135225 ms
Total Talk Time (CUSTOMER): 221540 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/b3d26b8c-7071-4697-9eb7-c598352a05bd_20250613T16:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] here calling on behalf of the essential office on a recorded line. How are you doing today?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] How can I help you today?
[CUSTOMER][POSITIVE] I have patience and in the eligibility and benefits.
[AGENT][POSITIVE] OK, I can help you with eligibility and benefits. Can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] It's 653-217.
[AGENT][NEUTRAL] I have 653-217.
[CUSTOMER][NEUTRAL] Yes, 653-217.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] I know.
[AGENT][NEUTRAL] And can you please um give me the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The name is
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] The patient name is [PII]. Last name is [PII].
[CUSTOMER][NEUTRAL] To
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] The date of birth?
[CUSTOMER][NEUTRAL] with
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[AGENT][POSITIVE] Thank you so much give me just one moment.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Alright, it looks like this policy is active with an effective date of [PII]. Did you wanna fax back for the benefits?
[CUSTOMER][NEUTRAL] I just have some specifications for this, so I have specific questions about this.
[AGENT][NEUTRAL] OK, give me just a moment, let me pull it up.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Please
[CUSTOMER][NEUTRAL] so I.
[AGENT][NEUTRAL] Alright, and what questions did you have?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I need a full breakdown for the patient including the uh group number and the group name.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] There is no group number or group name.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Thank you. And uh
[CUSTOMER][NEUTRAL] All right, sir. Now, no group number, no group name. The effective date is uh [PII] calendar plan, you will be standards for the patient. What is the plan maximum and the use amount including deductibles?
[AGENT][NEUTRAL] It looks like he has a calendar year maximum of $1000.
[AGENT][NEUTRAL] With a calendar year deductible.
[CUSTOMER][NEUTRAL] it
[AGENT][NEUTRAL] Of $50.
[AGENT][NEUTRAL] And up to $150 per family.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] All right, thank you and uh.
[AGENT][NEGATIVE] And the deductible does not apply to exams or cleanings.
[CUSTOMER][NEUTRAL] Anything else, please?
[CUSTOMER][NEUTRAL] Anything has been used out of 1000?
[AGENT][NEUTRAL] Uh, yes, that's the calendar year maximum.
[CUSTOMER][NEUTRAL] I know. Anything has been used like uh any accumulate?
[AGENT][NEUTRAL] Oh no, it's just the calendar year maximum and the deductible and then we go by a benefit amount.
[CUSTOMER][NEUTRAL] So no use amount, right? It's still remaining the same 1000?
[AGENT][NEUTRAL] Oh, were you asking if you've used anything? Give me just a moment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] At one usage and the zip code is [PII].
[AGENT][NEUTRAL] OK, let me check.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] He has not used any of his benefits yet, to date. No, ma'am. No, sir.
[CUSTOMER][NEUTRAL] No use, right? OK. So no other benefits for the patient, no waiting period, no missing tooth clots, right?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEGATIVE] It does have a missing tooth claws.
[CUSTOMER][NEUTRAL] OK. And uh.
[CUSTOMER][NEUTRAL] Co-insurance for diagnostic and preventative, basic and measure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] This does have basic and major, yes, sir.
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And it includes oral surgery as well.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] All right, thank you. So, it's 180 and 50 and then the period and the all occur under
[CUSTOMER][NEUTRAL] Mm, major is 50, right? And the period0 rule and we don't takes are covered under the basic 50 and the other one is uh for.
[CUSTOMER][NEUTRAL] Major services for periodontic surgical as well, correct?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Yeah, it looks like this covers um
[AGENT][NEUTRAL] Basic cleanings and diagnostic, restorative, major restorative, uh, periodontics, prosthetics.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] yeah
[CUSTOMER][NEUTRAL] I'm.
[AGENT][NEUTRAL] Um, an oral surgery.
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Right, same thing.
[AGENT][NEUTRAL] Did you have any other questions I can help you with?
[CUSTOMER][NEUTRAL] All right, so
[CUSTOMER][NEUTRAL] is there any history that affects the frequency for FMX pain or any other history that affects the frequencies?
[AGENT][NEUTRAL] Are you asking how, how often he's allowed certain procedures? I'm sorry, I can't hear you.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] History, history. The patient, is there any history?
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] So I can move over to our next question.
[AGENT][NEUTRAL] Is there any procedure code you need to look, or you need me to look up for you?
[CUSTOMER][NEUTRAL] Yes, for FMXL panel 0210 rightwing 0274.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] I'm gonna, I'm gonna have to go one by one. So was the 1st 1 0120?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 0210.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Uh, there is no history for that one.
[CUSTOMER][NEUTRAL] Yeah one
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And for between 0274?
[AGENT][NEGATIVE] I'm not showing anything for that either.
[CUSTOMER][POSITIVE] Thank you right now.
[CUSTOMER][NEUTRAL] OK. And you said your name is, sorry?
[AGENT][NEUTRAL] [PII], last initial [PII]
[CUSTOMER][NEUTRAL] Sorry, what was that? [PII], right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] 732
[CUSTOMER][POSITIVE] Thank you so much. All right then, [PII], I'm done with this information now. So thank you for your time. I appreciate it and have a great day. Thank you.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] You too. Take care. Bye-bye.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] All right. Thank you. Bye-bye.
[AGENT][NEUTRAL] OK, bye.