AccountId: 011433970860
ContactId: fe614c3d-f386-4965-bc68-b893866f4b69
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 301880 ms
Total Talk Time (AGENT): 128263 ms
Total Talk Time (CUSTOMER): 96676 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/fe614c3d-f386-4965-bc68-b893866f4b69_20250530T16:43_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]. I'm calling from Aspen Dental. How are you doing today?
[AGENT][POSITIVE] I'm doing well, Ms. [PII]. How are you doing?
[CUSTOMER][NEUTRAL] I'm doing well. I just had a couple of questions that we received a fax back with um information for patient that's currently about to be consulted. However, looking at the breakdown that was sent, there is nothing on here in regards to if she has any major services as far as like dentures, bridges, or crowns.
[AGENT][NEGATIVE] Right, so if it's not on the fax back then it's not covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I'm gonna assume um as far as like major services she doesn't have any at all.
[AGENT][NEUTRAL] Let me, um, pull up the policy. Can I please get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK, and then what's [PII]'s date of birth, please?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] I'm sorry, the policy number.
[AGENT][NEUTRAL] The policy number, I apologize.
[CUSTOMER][NEUTRAL] Oh, policy number it is 02612914.
[AGENT][NEUTRAL] OK, let me pull her up real quick.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm really careful.
[AGENT][NEUTRAL] Yes, she has the low plan.
[AGENT][NEUTRAL] And it does not cover any major medical expenses, any major expenses. It's just preventative and basic.
[AGENT][NEUTRAL] And basic restorative it looks like.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] I'm just double checking one last thing.
[CUSTOMER][NEUTRAL] Um, is there a missing tooth loss for her?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am, um, that is on it's kinda it's on the first page towards the bottom.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So this policy does have a missing tooth clause.
[AGENT][NEUTRAL] And TMJ services are not covered. Orthodontic treatment is not covered. Implant placement, removal and all related services are not covered.
[CUSTOMER][NEUTRAL] Um, can I ask one last quick question as far as oral surgery, um, cause that's what she's in here for. Um, she needs to see a specialist tomorrow. Is that covered, um, as far as extractions for oral surgery?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] What is the code?
[CUSTOMER][NEUTRAL] So the codes that she needs, give me one second, are.
[CUSTOMER][NEUTRAL] Let's see here.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me look.
[AGENT][NEUTRAL] And this is just to verify benefits. It's not a guarantee of payment. I'm trying to search that right now. I don't see it on the fax back.
[CUSTOMER][NEUTRAL] Yeah me sir.
[AGENT][NEUTRAL] Yes, ma'am, that's a non-covered service.
[CUSTOMER][NEUTRAL] OK, and then.
[CUSTOMER][NEUTRAL] 2, what about 7210 or 71 I see 7140.
[AGENT][NEUTRAL] OK, yes, that's on there.
[CUSTOMER][NEUTRAL] On here, but I don't think 7 to 0.
[AGENT][NEUTRAL] Let me check.
[AGENT][NEUTRAL] 7210 is also a non-covered service. It's not on the fax back.
[CUSTOMER][NEUTRAL] And you said she has a basic, I mean a preventative and basic plan.
[AGENT][NEUTRAL] Preventative, basic, and basic restorative.
[AGENT][NEUTRAL] Um, all the codes that are covered under the policy are the ones that the CVV code.
[AGENT][NEUTRAL] On the left hand side.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that would be what's covered and then on the right-hand side, the category of expense will tell you if it's preventative, basic or basic restorative.
[CUSTOMER][POSITIVE] OK, thank you so much for your help I appreciate it.
[AGENT][POSITIVE] Well, you're so welcome. Miss [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] No ma'am.
[AGENT][POSITIVE] OK, well, you have a wonderful weekend and thank you for calling APL.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye, ma'am.