AccountId: 011433970860
ContactId: 0e47f94b-e124-4785-ad2e-8af6b9fd1c50
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 309820 ms
Total Talk Time (AGENT): 119273 ms
Total Talk Time (CUSTOMER): 169493 ms
Interruptions: 8
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/0e47f94b-e124-4785-ad2e-8af6b9fd1c50_20250324T14:43_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APL. This is [PII] How can I help you?
[CUSTOMER][NEUTRAL] Yes, I was calling to get benefits and eligibility for dental on a patient. My name is [PII] like the address to our office.
[AGENT][NEUTRAL] Um, yes.
[AGENT][POSITIVE] OK. Thank you, [PII]. I can assist you with benefits. Um first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII] and there's no extension OK it's gonna be [PII]. Yeah, just just so you know that doesn't have like that if that's what you're trying to make sure that you do.
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] What do you need
[CUSTOMER][NEUTRAL] OK, [PII], date of birth is [PII].
[AGENT][NEUTRAL] OK. Please repeat that policy number.
[CUSTOMER][NEUTRAL] 00592821
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] OK, and please verify your name and date of birth one more time.
[CUSTOMER][NEUTRAL] That's correct, yes, [PII] [PII].
[AGENT][NEUTRAL] OK, thank you and just submit advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII] and the policy is still active and for a breakdown of the benefits and the fee schedule, I can fax that to you.
[CUSTOMER][NEUTRAL] I think yeah I think we had you at um.
[CUSTOMER][NEUTRAL] [PII] but I can check in.
[CUSTOMER][NEUTRAL] Um, the patient's actually in the chair now. Can we go over it over the phone?
[AGENT][NEUTRAL] Sure, ma'am. Yes, let me get that pulled up.
[CUSTOMER][NEUTRAL] The problem I'm sorry about that. I know sometimes it's hard to hear over the phone and everything, but um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK perfect all right thank you.
[AGENT][NEUTRAL] OK, yes, ma'am. I'm showing that there is a $750 calendar year maximum with a $50 deductible that needs to be met first. Let's see, have the deductible been met.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEGATIVE] Yeah, that's the swelling thing swelling place.
[CUSTOMER][NEUTRAL] OK, and the maximum has not been met either?
[AGENT][NEUTRAL] Right. The deductible has been met, but the maximum has not been met.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh well
[CUSTOMER][NEUTRAL] Oh, OK, I'm sorry, what's the, what, how much is left on the maximum?
[AGENT][NEUTRAL] OK. It's $750 and so far she's used.
[AGENT][NEUTRAL] $2119.20.
[CUSTOMER][NEUTRAL] Alright, and for preventative, basic and major, what are those percentages?
[AGENT][NEUTRAL] OK, for preventative, we cover it 100%.
[CUSTOMER][NEUTRAL] like
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] From basic we cover it 80%. Let's see.
[AGENT][NEGATIVE] And I'm not showing any major coverage on this policy.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Alright, um, uh, for endoonics, uh, specifically code D 3330, what's that code covered under?
[AGENT][NEUTRAL] OK, let's say 33, 30.
[AGENT][NEUTRAL] I'm showing that it's limited to one X-ray procedure every 5-year period.
[CUSTOMER][NEUTRAL] OK, is it under basic?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am. It's covered under basic.
[CUSTOMER][NEUTRAL] OK, and then what about code D 2954?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hey, OK, I have a quick question for you [PII] I need help.
[AGENT][NEUTRAL] OK. What was that code one more time, please?
[CUSTOMER][NEUTRAL] D 2954.
[CUSTOMER][NEGATIVE] She called this morning saying that y'all had resent the email twice she still hadn't gotten it, so I verified the email. It was wrong or like there was something wrong about it, so I changed it, sent it again, and she still said she didn't.
[CUSTOMER][NEUTRAL] Her um last name started with a [PII] anyway, long story short, now she's she's got.
[AGENT][NEUTRAL] OK, I'm not showing a 2954. I am showing a 2940 and a 2951.
[CUSTOMER][NEUTRAL] I had it in with the wrong last name.
[CUSTOMER][NEUTRAL] OK, alright, can I get a reference number?
[AGENT][NEUTRAL] Um, yes, for the reference number, you can use my name and today's date. My name is [PII], um, it's spelled [PII] My last initial is [PII], and today's date. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] B as in
[CUSTOMER][POSITIVE] That's gonna be it, thank you.
[AGENT][POSITIVE] Mhm. Thank you, [PII], for calling ATL. You have a great rest of your