AccountId: 011433970860
ContactId: da0b6e71-91a3-4946-aaa1-c9e428ec6828
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 292760 ms
Total Talk Time (AGENT): 155634 ms
Total Talk Time (CUSTOMER): 110641 ms
Interruptions: 3
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/da0b6e71-91a3-4946-aaa1-c9e428ec6828_20250306T21:19_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hey, this is [PII] at Day and Night Family Dental. I'm calling to see if I can get some information on a patient's dental plan.
[AGENT][POSITIVE] Yes, ma'am. [PII], I'll be glad to help you. Go ahead and give me your policy number.
[CUSTOMER][NEGATIVE] Oh, I lost it one second.
[AGENT][POSITIVE] OK, no problem.
[CUSTOMER][NEUTRAL] OK, here we go
[CUSTOMER][NEUTRAL] Can I get your name again too, please?
[AGENT][NEUTRAL] My, yes, ma'am. My name is [PII].
[CUSTOMER][NEUTRAL] Thank you. OK, member's ID is 02441184.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alrighty. [PII], thank you for that information. Now while I'm pulling this up, go ahead and give me a good return telephone card number, please.
[CUSTOMER][NEUTRAL] This would also
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alrighty [PII], thank you so much for all that information. Now your patient's name and date of birth today please ma'am.
[CUSTOMER][NEUTRAL] And you cover the.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] It looks like Blowwood is the insured on his dental plan. They show his original effective date is [PII]. He is still current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim. But you did say you want to fax back a benefit harmony. Is that, is that correct?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] No, ma'am, I just need to know how much he's used out of his max deductible and if there's any history that would affect frequency.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] All [PII], I can help you with that. Let me get over to that screen. Let's see.
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] If I can top this late, let's see, there we go.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEGATIVE] OK, he's not used any of his [PII] benefits here at all.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I think it might matter, he did have a panel done on [PII] along with the oral exam.
[CUSTOMER][NEUTRAL] Can.
[CUSTOMER][NEUTRAL] 0140 lightning.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] Do you know what is he having done today or?
[CUSTOMER][NEUTRAL] Give me one moment sorry I.
[CUSTOMER][NEUTRAL] Um, he's having a cleaning. Uh, when was his last prophy?
[AGENT][NEUTRAL] Mhm. Well, let's see about that then.
[CUSTOMER][NEUTRAL] For calendar year.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] He had by wings on [PII] along with an office visit.
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] Yeah, I just share frequency with.
[AGENT][NEUTRAL] And of course that pan though he had 24 no.
[AGENT][NEUTRAL] That's really it that would affect it.
[CUSTOMER][NEUTRAL] 016
[CUSTOMER][NEUTRAL] OK, but what was his last pro fee?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That's probably was it?
[CUSTOMER][NEUTRAL] Just cleaning 11:10.
[AGENT][NEUTRAL] What's that procedure code?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, D 11:10.
[AGENT][NEUTRAL] Let's see if he's ever had that.
[CUSTOMER][NEUTRAL] And 0274.
[AGENT][NEUTRAL] No, he's never had a 11:10 at all here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, what about um scaling and route planning? Those are codes 43, 41 and 4342?
[AGENT][NEUTRAL] Uh, let me get that fax back pulled up let's see if that's covered.
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] Per calendar year
[AGENT][NEUTRAL] So bear with me just a moment.
[CUSTOMER][NEUTRAL] And 02
[AGENT][NEUTRAL] That was 43, 41 and 43, 42, correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Uh let's see.
[CUSTOMER][NEUTRAL] One per day of service.
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] So one per day?
[CUSTOMER][NEUTRAL] Yeah, the one per day.
[CUSTOMER][NEUTRAL] Just put DOS one times DOS.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] 0 3:30.
[AGENT][NEUTRAL] 4341 and 4342 is covered under major here which uh let's see, is 12 month waiting period was over on 21, so he's OK with that.
[AGENT][NEUTRAL] Yes, ma'am. That is a covered benefit and the only, let's see, OK, is one maximum each quadrant per 24 months, but he's never had it, so.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] And can you verify that?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, he'd be good for that.
[CUSTOMER][POSITIVE] Alright, awesome, OK, is there a reference number for the call?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, [PII], we don't give reference numbers, but you can use my name in today's date if you need to do so. And is that all I can help you with?
[CUSTOMER][POSITIVE] That is thank you so much.
[AGENT][POSITIVE] OK. Yes, ma'am. [PII] and thanks for calling APL. Have a great day. Bye-bye.
[CUSTOMER][POSITIVE] Mhm, no problem you too bye bye.