AccountId: 011433970860
ContactId: cc1ad83f-4b2a-41e0-902e-c9a2992402ed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 429679 ms
Total Talk Time (AGENT): 108088 ms
Total Talk Time (CUSTOMER): 80719 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/cc1ad83f-4b2a-41e0-902e-c9a2992402ed_20250131T16:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII]. I'm calling from Jefferson Dental to verify you and the benefits.
[AGENT][NEUTRAL] All right. I'm happy to verify benefits. What's the patient's policy number, [PII]?
[CUSTOMER][NEUTRAL] Yeah, it's 02502835.
[AGENT][NEUTRAL] All right, let me pull that up here one moment.
[AGENT][NEUTRAL] And patient's name and date of birth?
[AGENT][NEUTRAL] Are you still there?
[CUSTOMER][NEUTRAL] Yeah, the patient's name is [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] Thank you. So the patient plan is active. The effective date is [PII].
[CUSTOMER][NEUTRAL] This patient is also subscriber?
[AGENT][NEUTRAL] I'm sorry, what was that again?
[CUSTOMER][NEUTRAL] This patient is also a subscriber?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Individual family and early max.
[AGENT][NEUTRAL] The calendar year max is going to be 1500.
[AGENT][NEUTRAL] Calendar year deductible is $50 per covered insured up to $150 per family.
[CUSTOMER][NEUTRAL] Individual 50, family 150, LA max 1500, right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You want to do basic measure, what are the percentages?
[AGENT][NEUTRAL] Basic is at 80% and majors at 40%.
[CUSTOMER][NEUTRAL] You want to do?
[AGENT][NEUTRAL] I'm sorry, what was that again?
[CUSTOMER][NEUTRAL] Preventative, what is the percentage for preventative?
[AGENT][NEUTRAL] Preventative is 100.
[CUSTOMER][NEUTRAL] 180 40.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And is the group number?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] 17626
[CUSTOMER][NEUTRAL] What is the group name?
[AGENT][NEUTRAL] Universal trucking.
[CUSTOMER][NEUTRAL] Universal trucking system.
[CUSTOMER][NEUTRAL] I know how much they used or met from the deductibles.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Patient has $50 deductible left and the full $1500 left for the year.
[CUSTOMER][NEUTRAL] How much they use, ma'am?
[AGENT][NEGATIVE] They've not used anything.
[CUSTOMER][NEUTRAL] Nothing new, nothing much. Patient is a subscriber, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, is any or lifetime max?
[AGENT][NEGATIVE] This plan has no ortho coverage.
[CUSTOMER][NEUTRAL] And I it effective date [PII], right.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Does, uh, is there any waiting period?
[AGENT][NEUTRAL] Uh, there's a 12-month waiting period for major endodontic, periodontic, and oral surgery.
[CUSTOMER][NEUTRAL] 12 months for basic major.
[CUSTOMER][NEUTRAL] On May 12 month waiting period, right?
[AGENT][NEUTRAL] No waiting
[AGENT][NEUTRAL] Right. Major is a waiting period of 12 months, endodontic, periodontic, and oral surgery.
[CUSTOMER][NEUTRAL] Does missing tooth cloths apply?
[AGENT][NEUTRAL] Yes, this policy does have a missing tooth clause.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 6104 is covered under this plan.
[AGENT][NEUTRAL] Let me check. 6104, 1 moment.
[AGENT][NEUTRAL] 6104 is not listed, therefore it's not covered.
[CUSTOMER][NEUTRAL] Is there any history that might affect the frequency?
[AGENT][NEGATIVE] No history on file.
[CUSTOMER][NEUTRAL] What is the fee schedule for this?
[AGENT][NEUTRAL] This one pays by UCR fee schedule?
[CUSTOMER][NEUTRAL] You see
[CUSTOMER][NEUTRAL] UCR
[CUSTOMER][NEUTRAL] Do you consider denta max?
[AGENT][NEUTRAL] I'm sorry, what was that again, [PII]?
[CUSTOMER][NEUTRAL] Reschedule
[AGENT][NEUTRAL] Yes, it pays by UCR fee schedule.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Yeah. OK, thank you. Uh, what is the call reference number?
[AGENT][NEUTRAL] Call reference is my name with my last initial and today's date. My name again is [PII], that's [PII] Last initial to my name is [PII].
[CUSTOMER][POSITIVE] Uh, thank you very much. uh, I'm done with the patient. Thank you.
[AGENT][POSITIVE] You're welcome have a good day.
[CUSTOMER][POSITIVE] Bye bye take care.