AccountId: 011433970860
ContactId: dbdec955-91f0-4bf9-a260-0448fb65321f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 532760 ms
Total Talk Time (AGENT): 260351 ms
Total Talk Time (CUSTOMER): 105871 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/dbdec955-91f0-4bf9-a260-0448fb65321f_20250203T16:59_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, ma'am, I called earlier, um, for I was waiting for a fax on a patient, um, and I haven't received it. I was just calling to see if I can just get that information, um, verbally.
[AGENT][NEUTRAL] OK, I can take a look at that for you. Can I get your name?
[CUSTOMER][NEUTRAL] Yes, ma'am. My name is [PII].
[AGENT][NEUTRAL] And [PII], if I could get a call back number please.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] It is 02516823.
[AGENT][NEUTRAL] Hold one moment, sorry.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Sorry, my monitor went out.
[AGENT][NEUTRAL] What in the world just happened. OK, let me pull.
[AGENT][NEUTRAL] OK, what is that policy number one more time?
[CUSTOMER][NEUTRAL] It's 02516823.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's for [PII], um, date of birth of [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Let's see and you said you are calling about um.
[AGENT][NEUTRAL] Getting some information regarding the benefits for this policy.
[CUSTOMER][NEUTRAL] Yes, ma'am. If I'm able to get um the any deductible.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For the picture.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I have that pulled up and let me get.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, please be advised verifying benefits is not guaranteed payment. Uh, this policy does have a $50 deductible. At this time I show it has not been met.
[CUSTOMER][NEUTRAL] OK. And would you be able to tell me what is covered under basic?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK. So, you want every procedure or, uh, it's probably easier to provide a procedure. All right, let me get here.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Um, I can go down each procedure if.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, so for basic um.
[AGENT][NEUTRAL] Let's see, intraoral complete series including bite wings.
[AGENT][POSITIVE] Uh, panoramic panoramic film.
[AGENT][NEGATIVE] Would be covered. I'm sorry, that's not correct. Basic uh oral evaluation, problem focused.
[AGENT][NEUTRAL] Uh, a detailed and extensive oral evaluation.
[AGENT][NEUTRAL] Uh, intraoral.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Pickle first film.
[AGENT][NEUTRAL] Um, each additional film.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let's see, a clusal film.
[AGENT][NEUTRAL] First film extraoral, uh, first film.
[AGENT][NEUTRAL] Extraoral each additional film.
[AGENT][NEUTRAL] Uh, vertical bite wings, 7 to 8 films.
[AGENT][NEUTRAL] Uh, posterior, interior, or lateral skull and facial bone survey film.
[AGENT][NEUTRAL] Let's see, pulp vitality test.
[AGENT][NEUTRAL] Um, let's see, a session of tissue.
[AGENT][NEUTRAL] Coronal remnants.
[AGENT][NEUTRAL] Extraction erupted tooth or exposed root.
[AGENT][NEUTRAL] And let's see, consultation, diagnostic service provided by dentist or physician other than practitioner providing treatment. And then, uh, there are basic, uh,
[AGENT][NEUTRAL] Restore active expenses.
[AGENT][NEUTRAL] Uh, amalgam one surface, primary or permanent.
[AGENT][NEUTRAL] Uh, amalgam to services primary or.
[AGENT][NEUTRAL] Permanent.
[AGENT][NEUTRAL] And then let's see, amalgam 3 surfaces, primary or permanent, amalgam 4 or more surfaces primary or permanent.
[AGENT][NEUTRAL] Uh, let's see, resin based composite, one surface, anterior, 2 surfaces anterior, 3 surfaces interior, 4 or more surfaces or involving.
[AGENT][NEUTRAL] Uh, angles, one surface posterior, 2 surfaces posterior, 3 surfaces posterior, 4 or more surfaces posterior. Uh, see here, gold foil, 1 surface, 2 surface, and 3 surface, uh, sedative filling.
[AGENT][NEUTRAL] And pin retention per tooth in addition to restoration.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you have any other
[CUSTOMER][NEUTRAL] As far as um
[CUSTOMER][NEUTRAL] I'm sorry. Um,
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Like the
[CUSTOMER][NEUTRAL] I don't know if you need a code. I have like uh endodonics or 3220. Is that under major?
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] 3220. I do not show that as a covered. Let me make sure let's say 3220, here we are.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] It is under endodontic expenses, a covered benefit.
[CUSTOMER][NEUTRAL] Would that be under basic or major?
[AGENT][NEUTRAL] Let me make sure that.
[AGENT][NEUTRAL] Say the 3 digits
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] That is under major.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And then as far as the um restorative, I know you were mentioning amalgam and resin for the posteriortes, um, do, does that downgrade?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do the resins downgrade to amalgam?
[AGENT][NEUTRAL] Let me check that.
[AGENT][NEUTRAL] It does.
[CUSTOMER][NEUTRAL] Um, I do have a
[CUSTOMER][NEUTRAL] The person I spoke to before mentioned to me that the, the payer ID is 60801. Did I write that correctly? OK. And then I do have one more question as far as um the group name. Is there a, a group name to the plan?
[AGENT][POSITIVE] That is correct. Yes, ma'am.
[AGENT][POSITIVE] Yes, let me get that for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] The group name is.
[AGENT][NEUTRAL] Universal Trucking Assin trucking.
[CUSTOMER][NEUTRAL] You know like.
[CUSTOMER][NEUTRAL] Universal ascent trucking.
[AGENT][NEUTRAL] Oh, it has universal trucking, ascend trucking.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] I think that should be all.
[CUSTOMER][POSITIVE] No, ma'am. You've been a lot of help. Thank you so much. I appreciate it.
[AGENT][POSITIVE] You're welcome. You have a wonderful day. Thank you for calling [PII].
[CUSTOMER][POSITIVE] You too. Thank you. Bye.
[AGENT][NEUTRAL] Bye bye.