AccountId: 011433970860
ContactId: d0034025-5e27-4000-8f73-bd822d99c477
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 184330 ms
Total Talk Time (AGENT): 62752 ms
Total Talk Time (CUSTOMER): 62099 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/d0034025-5e27-4000-8f73-bd822d99c477_20250103T15:32_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh yes ma'am, um, I'm from a dental office. Uh, I called earlier and got the breakdown of the benefits, uh, but the girl that uh said there was gonna be a fee schedule uh attached and I didn't get any fees.
[AGENT][NEUTRAL] What is your name and the callback number for you?
[CUSTOMER][NEUTRAL] Uh, [PII] area code [PII].
[AGENT][NEUTRAL] Thank you, [PII] and what is the policy number of the member?
[CUSTOMER][NEUTRAL] OK, 01641196.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII] [PII].
[AGENT][NEUTRAL] Thank you. So basically you're calling in regards to this claim, the breakdown. Did someone send over, did someone actually send over a dental schedule for you?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So, I'm not sure what the um
[AGENT][NEUTRAL] Adjuster was inquiring in regard referring to in regards to the fee schedule. however, there's no set fee amount scheduled for this policy is based on user and customary so the information that she sent over to you is exactly explanatory of how it's paid out. So preventative is covered at 100% of user and customary, basic is covered at 80% of user and customary. Major is covered at 40% of user and customary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, could you give me what you all would pay out for a cleaning a D1110 just to give me an idea.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] What is your zip code?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the procedure called?
[CUSTOMER][NEUTRAL] D1110.
[AGENT][NEUTRAL] We'll pay up to $103.
[CUSTOMER][NEUTRAL] 103 OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, how about a D0150?
[AGENT][NEUTRAL] Up to 102.
[CUSTOMER][NEUTRAL] OK, and D 0274?
[AGENT][NEUTRAL] Up to $74.
[CUSTOMER][POSITIVE] Perfect, that's what I need to know. Thank you so much.
[AGENT][POSITIVE] You're welcome thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK mhm bye bye.