AccountId: 011433970860
ContactId: 051a6c13-d0ce-4069-9367-ecde18dedcd4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 189539 ms
Total Talk Time (AGENT): 86328 ms
Total Talk Time (CUSTOMER): 37602 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/051a6c13-d0ce-4069-9367-ecde18dedcd4_20250407T19:56_UTC.wav
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[AGENT][POSITIVE] Thanks for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, I'm trying to locate a patient's policy.
[AGENT][NEUTRAL] OK, I can help you with that. Um, can I get your name and a good callback number?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, are you, are you needing benefits or claim status or?
[CUSTOMER][NEUTRAL] Benefits
[AGENT][NEUTRAL] OK, do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Um, 02478110.
[AGENT][NEUTRAL] The patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, it's not a guarantee of payment basic outline of the policy. Policy is effective [PII]. It's currently active.
[AGENT][NEUTRAL] Um, I can send you a fax back of all the benefits, outlines everything, or if we need to go over anything on the phone, we can do that as well.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'll do a fax
[AGENT][NEUTRAL] OK, what's your fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Do you need any information while we're on the phone?
[CUSTOMER][NEUTRAL] Um, yes, what is your fee schedule?
[AGENT][NEUTRAL] Um, so it looks like this.
[AGENT][NEUTRAL] It's just gonna be based on what's reasonable and customary, so based on UCR 80% of UCR.
[AGENT][NEUTRAL] It doesn't have a certain dollar amount for each code, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, are there any waiting periods or missing two calls?
[AGENT][NEUTRAL] There is a missing two clause, um, and this is not a guarantee of payment based outline of the policy.
[AGENT][NEUTRAL] Uh, waiting period, they do have a waiting period for
[AGENT][NEUTRAL] Um, it's a 12 month waiting period for basic restorative major endo perio.
[AGENT][NEUTRAL] And prosthodontic repair.
[AGENT][NEGATIVE] Or actually there's no coverage for prosthooncor parabo. So 12 months for basic restorative, major, endo anderio.
[CUSTOMER][NEUTRAL] OK, um, and there's no ortho coverage correct?
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Um, no, I do not show any ortho coverage.
[CUSTOMER][NEUTRAL] OK, um, and could I get a reference number?
[AGENT][NEUTRAL] Reference number is gonna be my first name, [PII], first initial to last name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] OK, thank you for calling ATL have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye.