AccountId: 011433970860
ContactId: ce422194-ccd4-4f3d-9977-8882b5e76c58
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 378959 ms
Total Talk Time (AGENT): 180460 ms
Total Talk Time (CUSTOMER): 127874 ms
Interruptions: 0
Overall Sentiment: AGENT=2.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/ce422194-ccd4-4f3d-9977-8882b5e76c58_20250106T16:56_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hello there. This is [PII]. I'm looking for dental benefit for my patient.
[AGENT][POSITIVE] OK, yeah, I'd love to help you with some dental benefits today, my friend. Um, do you have
[AGENT][POSITIVE] Do you have a good call back number I can get from you real quick, my friend?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII] with no [PII] direct line.
[AGENT][POSITIVE] Wonderful. And the policy number?
[CUSTOMER][NEUTRAL] That will be 02150283.
[AGENT][POSITIVE] Perfect and let me get that pulled up real quick for you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] [PII], could you do me a favor and verify please your patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] All right, perfect.
[AGENT][NEUTRAL] Alright, I'm really sorry, but it looks like your patient is no longer active. It looks like the policy was effective from [PII] through March or I'm sorry, through [PII].
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Uh, so the termination date is [PII], right?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK, thank you. And uh I have like one more question left, can you also help me with that?
[AGENT][POSITIVE] I absolutely can. Do you mind giving me a moment to just get my notes typed in on this one?
[CUSTOMER][NEUTRAL] Sure. And before that, can you just spell your name for me?
[AGENT][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] OK, and uh the reference number?
[AGENT][NEUTRAL] It's gonna be my name, my last initial and today's date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right, and I am ready for that next policy number when you are, my friend.
[CUSTOMER][POSITIVE] Great
[CUSTOMER][NEUTRAL] Yeah, that will be 01822695.
[AGENT][POSITIVE] Wonderful and this patient's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] And then one more
[CUSTOMER][NEUTRAL] That will be [PII], [PII].
[AGENT][POSITIVE] Wonderful. This patient is current and active and I can go ahead and send you a fax back of benefits if you'd like.
[CUSTOMER][NEUTRAL] Uh, for this patient, I already have the benefit. I just want to check certain, uh,
[CUSTOMER][NEUTRAL] Uh, like, uh, certain things for this patient.
[AGENT][POSITIVE] OK, yeah. How can I help you with this one?
[CUSTOMER][NEUTRAL] Uh, for this patient, uh, is there any waiting period?
[AGENT][NEUTRAL] All right, so it's gonna be what's listed on the fax back those items there are the 12 month waiting period. Uh, he's been effective since [PII] though, so it looks like he's passed that he should be good for everything.
[CUSTOMER][NEUTRAL] So there is no waiting period?
[AGENT][NEUTRAL] Well, there is, but he's met it.
[CUSTOMER][NEUTRAL] OK, so there is no waiting period, right? And uh, any missing.
[AGENT][NEUTRAL] Yeah, he's met, he's met that limit.
[CUSTOMER][NEUTRAL] And, yeah, any missing tooth cloth?
[AGENT][NEUTRAL] Um, again, that's listed on the fax back this policy does have a missing tooth clause.
[CUSTOMER][NEUTRAL] OK. And uh I just want to uh get the history for this patient also.
[AGENT][NEUTRAL] OK, yeah, let me pull that up for you.
[AGENT][NEUTRAL] Um, do do do do do.
[AGENT][NEUTRAL] All right, what, um, what are we wanting to look at?
[CUSTOMER][NEUTRAL] Uh, his face that affect the current frequency for this patient.
[CUSTOMER][NEUTRAL] And uh.
[AGENT][NEUTRAL] OK, um,
[AGENT][NEUTRAL] So are you wanting to look at like cleanings and pro like I guess I need to know explicitly like what or unless do you want me to give you everything he's ever had on file?
[CUSTOMER][NEUTRAL] No, I just want to take the history from basic and measure or preventative that might affect the current frequency for this patient.
[AGENT][NEUTRAL] OK, I guess.
[AGENT][NEUTRAL] I'm
[AGENT][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] [PII], he had procedure code 0110, sorry, is that 3,101,110.
[AGENT][NEUTRAL] And he, so that will be 6 months, I believe, before he's eligible. It should be March of next year again.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm so sorry. When I'm looking at this, I don't know what the procedure code for crowns and bridges or bite wings or any of that. I really do need you to give me more like specific information that you're looking for. Um, I'm so sorry.
[CUSTOMER][NEUTRAL] OK. And uh
[CUSTOMER][NEUTRAL] 274-029-50
[AGENT][NEUTRAL] 01 at a time.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] OK. 2740.
[AGENT][POSITIVE] All right, perfect.
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Uh, looks like we last did that on [PII].
[CUSTOMER][NEUTRAL] And uh he's eligible for now?
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] It looks like crown say once every tooth per every tooth every 7 years. Um, it's not been 7 years since [PII]. If he needs it on the same tooth, it looks like it was done on tooth number 14 and tooth number 3.
[CUSTOMER][NEUTRAL] This
[CUSTOMER][NEUTRAL] OK. And uh 2391?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 02391 uh last time we did that was [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Um, but it was denied, so.
[CUSTOMER][NEUTRAL] What about the code, uh, like, uh,
[CUSTOMER][NEUTRAL] Those uh
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] 02