AccountId: 011433970860
ContactId: fb91470e-6098-49c3-b094-fc59ecc0f7a9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 557340 ms
Total Talk Time (AGENT): 103521 ms
Total Talk Time (CUSTOMER): 164532 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/fb91470e-6098-49c3-b094-fc59ecc0f7a9_20250610T19:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I was calling to see if a patient's plan is still active, and I was hoping to get some sort of breakdown over the phone.
[AGENT][POSITIVE] OK, I can help you with eligibility and benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] I do it's [PII].
[AGENT][NEUTRAL] And the policy of the number of the patient?
[CUSTOMER][NEUTRAL] 614-4441
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Excuse me, it is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, it looks like this policy is active and effective [PII].
[AGENT][NEUTRAL] And so this is, they pay a certain dollar amount for chart for the codes. I can send you a fax back that lists all the codes in their reimbursement amount.
[AGENT][NEUTRAL] Um, it also includes frequency and duration.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, are you not able to give me a breakdown? Um, he's coming in later today.
[AGENT][NEUTRAL] Yeah, I can give you a breakdown, but I, I mean, there's several codes, like many, many codes on here. Are you needing to check the reimbursement for codes or?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah, yeah, so there's where we have like this sheet that we have to fill out there. It is code based, um, I mean it's not all of the ones that are gonna come in the fax, but it's quite a few of them.
[AGENT][NEUTRAL] OK, that's what I'm saying. Do you have access to a fax because that has all of the list of codes that I can send to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, I understand what you're saying, but I was hoping to get one over the phone already so that don't have to wait on the fax and go over the fax myself. Is that OK?
[AGENT][NEUTRAL] Yeah, that's fine.
[CUSTOMER][POSITIVE] Thanks.
[CUSTOMER][NEUTRAL] Let me know when you're ready for the goods please.
[AGENT][NEUTRAL] OK, give me just a moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK. What's the first code?
[CUSTOMER][NEUTRAL] OK, so we're gonna start with 01201110. Let me know how many you want at a time, please.
[AGENT][NEUTRAL] One at a time.
[CUSTOMER][NEUTRAL] OK, uh, 0120.
[AGENT][NEUTRAL] Based on a guarantee payment, basic outline of the policy, it's 15.
[CUSTOMER][NEUTRAL] OK, and then 11:10.
[AGENT][NEUTRAL] OK, and OK, the first code you said was 0110?
[CUSTOMER][NEUTRAL] Yeah, um, I think I said 0120 1st, they're next to each other, so I was just doing both.
[AGENT][NEUTRAL] OK, 0120 is 15, 1110 is 40.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] 0140.
[AGENT][NEUTRAL] 25.
[CUSTOMER][NEUTRAL] 0180.
[AGENT][NEUTRAL] I don't show it covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 208.
[AGENT][NEGATIVE] It's not covered.
[CUSTOMER][NEUTRAL] OK, uh, 1351.
[AGENT][NEUTRAL] 24.
[CUSTOMER][NEUTRAL] Is there any age limit on that?
[AGENT][NEUTRAL] 14.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 0274.
[AGENT][NEUTRAL] Uh, it's $20 once every 6 months.
[CUSTOMER][NEUTRAL] OK, 20.
[CUSTOMER][NEUTRAL] OK, uh, 0220.
[AGENT][NEUTRAL] $10.
[CUSTOMER][NEUTRAL] 0330.
[AGENT][NEUTRAL] Uh, it's 35.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's once every 3 years?
[CUSTOMER][NEUTRAL] Um, on 2393.
[AGENT][NEUTRAL] Um, I don't have 2393.
[CUSTOMER][NEUTRAL] Is there any coverage on fillings at all?
[AGENT][NEUTRAL] You have a certain code?
[CUSTOMER][NEUTRAL] Let me, that's the one that we have listed here.
[CUSTOMER][NEUTRAL] It hasn't really any filling code will do. Let me see if I can find one.
[CUSTOMER][NEUTRAL] I don't know them by heart.
[CUSTOMER][NEUTRAL] 0 2391 or 92?
[AGENT][NEUTRAL] I don't show either of those covered. He's got several old codes for amalgam and resin.
[AGENT][NEUTRAL] They're all different dollar.
[CUSTOMER][NEUTRAL] OK, are they?
[CUSTOMER][NEUTRAL] OK, well
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] skip that, uh, 2740.
[AGENT][NEUTRAL] 2:15.
[CUSTOMER][NEUTRAL] 2:15.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 5110.
[AGENT][NEUTRAL] 200.
[CUSTOMER][NEUTRAL] 6750.
[AGENT][NEUTRAL] 180.
[CUSTOMER][NEUTRAL] 4355.
[AGENT][NEUTRAL] 25.
[CUSTOMER][NEUTRAL] 4346.
[AGENT][NEUTRAL] I don't show it covered.
[CUSTOMER][NEUTRAL] 4910.
[AGENT][NEUTRAL] 35.
[CUSTOMER][NEUTRAL] 4 4341.
[AGENT][NEUTRAL] 72.
[CUSTOMER][NEUTRAL] 9944.
[AGENT][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] 6010.
[AGENT][NEGATIVE] Um, implants aren't covered, not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 9243 sedation.
[AGENT][NEGATIVE] Uh, not covered.
[CUSTOMER][NEUTRAL] 9310.
[AGENT][NEUTRAL] Uh, 15.
[CUSTOMER][NEUTRAL] 0431.
[AGENT][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 9110.
[AGENT][NEUTRAL] That's 15.
[CUSTOMER][NEUTRAL] For the 91 cents?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 0460.
[AGENT][NEUTRAL] 16.
[CUSTOMER][NEUTRAL] And then I have 0365 and then Ortho 8090.
[AGENT][NEGATIVE] And neither of those are covered.
[CUSTOMER][NEUTRAL] OK, perfect. May I please have a reference number?
[AGENT][NEUTRAL] That's my name is [PII], and today's date.
[CUSTOMER][POSITIVE] OK awesome thank you so much.
[AGENT][POSITIVE] OK, thanks for calling ATL. Have a good day.
[CUSTOMER][NEUTRAL] Bye bye.