AccountId: 011433970860
ContactId: d59c51f9-0899-4260-894c-dc4eceaaf543
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305209 ms
Total Talk Time (AGENT): 125066 ms
Total Talk Time (CUSTOMER): 122607 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/d59c51f9-0899-4260-894c-dc4eceaaf543_20250319T14:24_UTC.wav
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[AGENT][POSITIVE] Good morning and thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh, yes, I was just speaking with a representative. We got disconnected, um, I was getting benefit information for a patient.
[AGENT][NEUTRAL] OK, uh, is this [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I was talking to you and I, I was just talking away and I looked up and it was like, oh, it's gone. I'm sorry.
[CUSTOMER][NEUTRAL] I don't know what happened.
[AGENT][NEUTRAL] It didn't the phone didn't want to take, but um, yes, and I still have it up. You still need benefits or have benefit questions.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Yes, the yes, replacement periods for crowns, bridges, and dentures.
[AGENT][NEUTRAL] Oh, OK, and I just speaking away, uh, crowns and bridges are once every 7 years, partials dentures every 5.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And is it a calendar year policy?
[AGENT][NEUTRAL] It is, yes, ma'am.
[CUSTOMER][NEUTRAL] Is there any missing two calls or waiting periods?
[AGENT][NEUTRAL] Uh, there is a missing tooth cloth, and let me double check. I believe she's already passed her waiting period.
[AGENT][NEUTRAL] Uh, and she is past her waiting period.
[CUSTOMER][NEUTRAL] Is their ortho coverage?
[AGENT][NEUTRAL] Uh, no, ma'am. Ortho is not covered under the policy.
[CUSTOMER][NEUTRAL] Alright and um frequencies on Pan and FMX?
[AGENT][NEUTRAL] Oh, once every 5 years.
[CUSTOMER][NEUTRAL] Bite wings
[AGENT][NEUTRAL] Uh, one for 12 month period.
[CUSTOMER][NEUTRAL] Um, exams like 0120, 0140.
[AGENT][NEUTRAL] Uh, exams are 2 for 12 month period and all exams share the same frequency.
[CUSTOMER][NEUTRAL] Cleanings I'm assuming are 2 per 12.
[AGENT][NEUTRAL] Uh, once every 6 months.
[CUSTOMER][NEUTRAL] OK, 1 x 6 is fluoride covered?
[AGENT][NEUTRAL] Uh, under the age of [PII].
[CUSTOMER][NEUTRAL] For adults
[CUSTOMER][NEUTRAL] And what is the frequency for SRP?
[AGENT][NEUTRAL] Uh, once every 24 months.
[CUSTOMER][NEUTRAL] Can you do all 4 quads in the same day?
[AGENT][NEUTRAL] Uh, yes, ma'am.
[CUSTOMER][NEUTRAL] And I wanna ask all these things does the patient have any history?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Uh, no, ma'am. She doesn't have any history.
[CUSTOMER][NEUTRAL] OK, no history, and I guess while I have you on the phone I'll go ahead and ask uh what is her deductible and maximum.
[AGENT][NEUTRAL] OK, uh, not a guarantee of payment, just a verification of coverage. She has a benefit max up to $1500 per calendar year, and she has a $50 deductible that is applied to everything but preventative services.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And preventative, is it covered at 100%?
[AGENT][NEUTRAL] 100% of UCR, yes, ma'am.
[CUSTOMER][NEUTRAL] Um, basic, what is it?
[AGENT][NEUTRAL] 80.
[CUSTOMER][NEUTRAL] 80 is uh endo and Pero considered basic?
[AGENT][NEUTRAL] Uh, no, ma'am. They're considered major, so it pays at 40%.
[CUSTOMER][NEUTRAL] Um, what about oral surgery?
[AGENT][NEUTRAL] Uh, 40, it's considered major, except for the 7140, that's considered basic.
[CUSTOMER][NEUTRAL] 40.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] And um implants or any implant placement or.
[AGENT][NEGATIVE] Uh, not covered.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] The implant nor the crown. Yes, ma'am.
[CUSTOMER][NEUTRAL] No cover, OK.
[CUSTOMER][NEUTRAL] If I can have a fax just so we can have the breakdown as well and um this is just an insurance verification form that I was filling out trying to make sure and I know and I I know you know as well not all the fax doesn't always cover all of that um so can I get a reference number real quick and then I can.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Give you our fax number if that'll work.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Yes, ma'am. Uh, you can use my name and today's date if you like.
[CUSTOMER][POSITIVE] What I'm so sorry, what is your name again? I apologize.
[AGENT][NEUTRAL] Oh, I'm sorry, it's [PII], last initial [PII]
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Yes, ma'am. And what's your fax number, Ms. [PII]?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] Well, no, let me go find it.
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, that's [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, um, and is there anything else I can assist you with today, Ms. [PII]?
[CUSTOMER][POSITIVE] Thank you so much. You answered all my questions. I really appreciate it.
[AGENT][POSITIVE] Oh, you're welcome. Uh thank you for calling APL and you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.