AccountId: 011433970860
ContactId: e502d37f-9957-4d25-91ad-b4ed30720d46
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 453070 ms
Total Talk Time (AGENT): 159367 ms
Total Talk Time (CUSTOMER): 181918 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/2025/01/15/e502d37f-9957-4d25-91ad-b4ed30720d46_20250115T16:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling with Martin Dental. I just have a question in regards to patient benefits.
[AGENT][NEUTRAL] OK, I can help you with benefits, Miss [PII]. Um, can I please get your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you ma'am and then what's the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And then what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] And [PII]'s policy number, please?
[CUSTOMER][NEUTRAL] 02555230
[AGENT][NEUTRAL] OK, let me pull that policy in for us real quick.
[AGENT][NEUTRAL] OK. I do show that [PII] does have an active policy and her effective date is, let's see.
[AGENT][NEUTRAL] 11 of 2024.
[CUSTOMER][NEUTRAL] 11, not 101.
[AGENT][NEUTRAL] You're correct, that is 10-1 of 2024. I apologize.
[CUSTOMER][NEUTRAL] So the 12 months would be up on 101 of 25.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So specific question I know it's not gonna pertain to her but.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Fluoride application, so I got a fax back yesterday, um, however, on the schedule of covered dental services.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, all of the fluoride, those codes don't exist anymore, but the codes that do exist aren't listed.
[CUSTOMER][NEUTRAL] If that makes sense.
[AGENT][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] So we go by the um the schedule that was sent to you. I can make sure that I'm gonna write this down, make sure that the fluoride.
[AGENT][NEUTRAL] Codes
[AGENT][NEUTRAL] Don't exist is what you said?
[CUSTOMER][NEUTRAL] So the floor codes that are listed on the fax back.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Are the 1201030405 those are no longer active in the CDT codebook.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and the codes that are active are 1206 and 1208, and those are not listed on here, so I didn't know if it was just like not a covered service or the fact that this list hasn't maybe been updated in a few years because those codes have been gone for a while.
[AGENT][NEUTRAL] OK. Um, I will have to
[AGENT][NEUTRAL] get with our team and see about getting those codes updated if they need to be.
[AGENT][NEUTRAL] But until then it'll have to be by the fee schedule that was sent to you um I've got your phone number so I can make sure somebody calls you back and lets you know if those are going to be changed.
[CUSTOMER][NEUTRAL] And then there's a couple that aren't on here that I wanted to inquire about.
[AGENT][NEUTRAL] And if, if it's not on the fee schedule, then it's a non-covered service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's interesting because a lot of this is like outdated stuff.
[CUSTOMER][NEUTRAL] With current CDT codes.
[AGENT][NEUTRAL] OK. I will make sure that I address that.
[AGENT][NEUTRAL] And if it needs to be changed we will definitely update it um but I I need to go through the proper channels to do that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, um, I'll make sure that I reach out to somebody today and have them look at it and then uh.
[AGENT][NEUTRAL] Call you back if we did change it.
[CUSTOMER][NEUTRAL] Uh, can I give you the codes that aren't listed on here that might be part of the policy but just not updated?
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] So at least they're looking into the ones that I'm specifically looking for.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Um, so it's those fluoride codes and again I know due to her um age limitations she wouldn't be covered, but in the event that there was a child added to the plan we would just need to know, um, and then D4355.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Um, which is full multibrment.
[AGENT][NEUTRAL] The 4355. OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Which is full master bridement.
[CUSTOMER][NEUTRAL] I don't see it listed on here.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm writing this down.
[CUSTOMER][NEUTRAL] And then
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, D 9945.
[CUSTOMER][NEUTRAL] Which is a soft guard.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] D 9946
[AGENT][NEUTRAL] What was that again? D9946?
[CUSTOMER][NEUTRAL] 46 mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's a hard guard.
[CUSTOMER][NEUTRAL] It's on there because
[CUSTOMER][NEUTRAL] Um, and then D4342.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's scaling and rep planning.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think there's.
[CUSTOMER][NEUTRAL] And I think that.
[CUSTOMER][NEUTRAL] Might be it.
[AGENT][POSITIVE] OK, OK, and I'm gonna get right on this and make sure that because if it needs to be updated we surely need to take care of that so I'm gonna get right on it and get with the proper channels so that we can make sure that that if that needs to be updated we we take care of it.
[CUSTOMER][NEUTRAL] OK, and if they're not, um, if they're just not part of the policy, that's fine. I just wanted to make sure that that was addressed.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I will get on it and I appreciate you giving me that information.
[CUSTOMER][NEUTRAL] That is all I needed then.
[CUSTOMER][POSITIVE] Well I appreciate your help today [PII] thank you.
[AGENT][POSITIVE] You're welcome. You have a great day and thanks for calling APL M. [PII].
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.