AccountId: 011433970860
ContactId: f3a6b0fb-fa7d-49b8-b3bd-0c5f6a530682
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 281119 ms
Total Talk Time (AGENT): 68251 ms
Total Talk Time (CUSTOMER): 96396 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/f3a6b0fb-fa7d-49b8-b3bd-0c5f6a530682_20250108T22:00_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII]. I recently spoke to a lady and she didn't give me her name, so I apologize, but she said she's gonna fax me back or she's gonna fax me their um the schedule.
[CUSTOMER][NEUTRAL] Well she faxed me twice about like the codes and inform like dental codes that she covers.
[CUSTOMER][NEGATIVE] But I need like their fees.
[AGENT][POSITIVE] OK, I'd be happy to um assist with the fax back today, um.
[AGENT][NEUTRAL] I'm sorry, your first name again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] [PII] and [PII] if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 2 sorry 02487694.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information. Would be advised the verification of coverage is not a guarantee of payment.
[AGENT][NEUTRAL] Um, now I do show with this policy we go by UCR. It should say um that on the top of the fax back.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me look at a copy of it.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Oh, allowable, it says allowable, but it's UCR you're doing customary for your area.
[CUSTOMER][NEUTRAL] ECR.
[CUSTOMER][POSITIVE] OK, that's helpful.
[AGENT][NEGATIVE] And if you don't see a code listed on there, it means it's not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, it says um.
[CUSTOMER][NEUTRAL] Sorry, it says.
[CUSTOMER][NEUTRAL] I was curious about Rupe now.
[CUSTOMER][NEUTRAL] It says basic but doesn't sit in canals fall under basic but other than that does not specify.
[AGENT][NEGATIVE] I don't understand what you're saying.
[AGENT][NEUTRAL] You said what now?
[CUSTOMER][NEUTRAL] Like root canals.
[CUSTOMER][NEUTRAL] It root canals are covered under basic and it says basic, but.
[CUSTOMER][NEUTRAL] It does not possessify I can't say that word, uh, root canals.
[CUSTOMER][NEUTRAL] Specify
[AGENT][NEUTRAL] Well, what's the code that you're looking for?
[CUSTOMER][NEUTRAL] Oh well I can tell you that the dental code is.
[CUSTOMER][NEUTRAL] 1 2nd.
[CUSTOMER][NEUTRAL] Please please
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Dental code is 3330.
[AGENT][NEUTRAL] 3330, so 3330?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And the fax you get or the fax back it ends at, yeah.
[CUSTOMER][NEUTRAL] It doesn't say that one.
[AGENT][NEUTRAL] OK, so then that would not be a covered service if it's if the code is not on the fax back it means it's not covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, only preventative and basic are covered and that that's not what we, well, I guess what this policy considers to be basic or root canal would be a major service and major services are not covered under this policy.
[CUSTOMER][NEUTRAL] Right, I'll let him know, yeah.
[CUSTOMER][NEUTRAL] OK, I'll let him know.
[AGENT][NEUTRAL] OK, was there anything else I could assist with today?
[CUSTOMER][POSITIVE] Um, no, thank you so much for your help.
[AGENT][POSITIVE] Well, thank you for calling.
[AGENT][POSITIVE] [PII] you have a good day.
[CUSTOMER][NEUTRAL] Mhm.