AccountId: 011433970860
ContactId: f33bd45e-c39e-4bc8-bd56-f041ddd016ad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 216949 ms
Total Talk Time (AGENT): 131874 ms
Total Talk Time (CUSTOMER): 56386 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/f33bd45e-c39e-4bc8-bd56-f041ddd016ad_20250217T20:56_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] So my name is [PII]. I'm calling from Brightow Dental in [PII], and I'm trying to verify subscribers coverage with you.
[AGENT][POSITIVE] OK, sure, I can assist you with eligibility and benefits, Miss [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It's 02344629.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Um, yes, it's [PII], and the birth date is [PII].
[AGENT][NEUTRAL] Perfect, thank you. OK, we have an effective date of [PII]. It is active at the moment and do you need the benefit information given to you verbally or faxed over to you, Miss?
[CUSTOMER][POSITIVE] Um, if you can just give it to me verbally, that would be great.
[AGENT][NEUTRAL] Sure, yes, let me go ahead and pull the schedule benefits, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer and
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, we have a calendar year maximum of $1500 per cover insured with the $50 deductible and deductible does not apply to preventative.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Preventative start cover 100%.
[AGENT][NEUTRAL] Radiograph FMX is cover 80%.
[AGENT][NEUTRAL] Basic expense and basic restorative expenses cover 80%.
[AGENT][POSITIVE] OK. And then we have major service. Major service includes endodontics, periodontics, prosthodontic repair, and oral surgery. They're all covered at 40% after a 12 month waiting period, which is already out of the waiting period.
[AGENT][NEUTRAL] And then we have the frequent, uh, go ahead.
[CUSTOMER][NEUTRAL] OK and.
[CUSTOMER][NEUTRAL] Yep, go ahead, no, go ahead.
[AGENT][NEUTRAL] OK. Then we have the frequencies, uh, for cleanings, we have once every 6 months. Exams are 2 for 12 month period.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] By wings is once per 12 month period.
[AGENT][NEUTRAL] For my X-rays or panels are once every 5 years.
[AGENT][NEUTRAL] Crowns and bridges are once every 7 years per tooth.
[AGENT][NEGATIVE] Impartial and dentures are once every 5 years, and this policy does have a missing tooth cloth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, who do you guys have listed as the employer?
[AGENT][NEUTRAL] Um, let me check. I know it's universal trucking, but let me check. OK. Yes. All right.
[CUSTOMER][NEUTRAL] Not familiar with your company.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it's gonna be universal Trucking Baylor Trucking.
[CUSTOMER][NEUTRAL] Baylor Trucking right, and then we send the claims to [PII].
[AGENT][POSITIVE] Yes, that is correct. Mhm.
[CUSTOMER][POSITIVE] OK, alright, thank you so much, so for your help. I do appreciate it. You have a great day, OK?
[AGENT][POSITIVE] You're welcome. You as well, Ms. [PII], and thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.