AccountId: 011433970860
ContactId: de1ff865-87d3-4497-8fc1-7c23b160f4f7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 179279 ms
Total Talk Time (AGENT): 88892 ms
Total Talk Time (CUSTOMER): 58494 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/de1ff865-87d3-4497-8fc1-7c23b160f4f7_20250206T22:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, my name is [PII]. I'm calling from a dental provider's office, and I need to verify dental eligibility and get a breakdown of benefits.
[AGENT][NEUTRAL] OK, I can still set that, [PII], thank you. Uh, may I have your callback number if we were disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And what is the policy number, please?
[CUSTOMER][NEUTRAL] It is 02576308.
[AGENT][NEUTRAL] Thank you. And verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient is [PII] and her date of birth is [PII].
[AGENT][POSITIVE] Thank you so much. I have that number pulled up. You're calling for eligibility and the breakdown. Give me one second please, [PII]. Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I appreciate your patience. Uh, the member is a dependent on the plan with an effective date of [PII]. This policy currently shows active. Please note verification of benefits provided does not guarantee payment. We, excuse me, the member has a $500 calendar year max.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] With a $50 deductible per person, that's up to $150 for the family.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The plan covers preventative at 100% of allowable and basic services at 80%. There is no coverage for major.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, and is there a frequency limits?
[AGENT][NEUTRAL] Um, yes, prophies are once every 6 months, exams are 2 for 12, and that includes the limited.
[AGENT][NEUTRAL] Fluoride is 1 per 12 month period under the age of [PII], under preventative.
[AGENT][NEUTRAL] White wings are 1 per 12 month period, and they're preventative, and then FMX and pans are 1 per 5 year period, and those are covered under basic at 80%.
[CUSTOMER][NEUTRAL] And I'm sorry, exam was once every 12 months?
[AGENT][NEUTRAL] Um, exams are 2 per 12.
[CUSTOMER][NEUTRAL] For once every
[CUSTOMER][NEUTRAL] 2 times 12 months. OK, um, trophyloy by wings also fillings, um, do what is the frequency for fillings and do they downgrade?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] The frequency is 1 for 24 months and there are no downgrades.
[CUSTOMER][NEUTRAL] And uh endoperio oral surgery, does that all fall under major?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then we follow the Carrington fee schedule.
[AGENT][NEUTRAL] Yes, the plan does fall.
[CUSTOMER][POSITIVE] OK perfect thank you that's what I needed to know.
[AGENT][POSITIVE] You're welcome, [PII] and thank you for calling APL. Have a great day. Thank you.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Yeah.