AccountId: 011433970860
ContactId: 2a57a9e2-be30-446a-91ea-a28a34e29f76
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 648539 ms
Total Talk Time (AGENT): 161883 ms
Total Talk Time (CUSTOMER): 257657 ms
Interruptions: 1
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/2a57a9e2-be30-446a-91ea-a28a34e29f76_20250623T15:09_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hello, [PII]. My name is [PII] calling from dental office and I'm looking for dental benefits of the patient.
[CUSTOMER][NEUTRAL] Oh hey [PII], my name is
[AGENT][NEUTRAL] OK, I can help you with benefits. Did you say [PII] was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, the mobile number is [PII].
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, and the policy number of the patient?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm it is 243-748-87.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII], and [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] And the policy is effective [PII].
[AGENT][NEUTRAL] Then I can send over a fax back that outlines all of the codes covered and the frequency and duration unless there's something you need on the phone.
[CUSTOMER][NEUTRAL] Uh, no, we
[CUSTOMER][NEUTRAL] Uh yes, please.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, you want, you want those faxed?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Sure facts
[CUSTOMER][NEUTRAL] It is 615691-6189.
[AGENT][NEUTRAL] And then put it to your attention.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No, not canceled.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And is there anything you need to go over on the phone?
[CUSTOMER][NEUTRAL] Mm, yes, please. Um, is there, uh, can you tell me the history?
[AGENT][NEUTRAL] Um, the history, we've got.
[CUSTOMER][NEUTRAL] Uh, is that on the fax number, uh, the fax, the history.
[AGENT][NEUTRAL] No, uh, the history is not, but I'll give that to you now. Um, uh, only, only history I have on file, there was a cleaning an exam on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And fluoride, same date.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] The Last bite wings were [PII].
[AGENT][NEUTRAL] And they haven't used anything this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh this is, uh, how much is the auto lifetime maximum?
[AGENT][NEUTRAL] Uh, not a guarantee of payment, basic outline of the policy. We have an annual maximum benefit of 500 calendar year.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And they have a
[CUSTOMER][NEUTRAL] And auto is not deducted. Yes.
[AGENT][NEUTRAL] The deductible is $50.
[AGENT][NEUTRAL] That will be for radiographs, basic and basic restorative expenses.
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[CUSTOMER][NEUTRAL] And family deductibles.
[AGENT][NEUTRAL] I'm 50.
[CUSTOMER][NEUTRAL] OK. And nothing has been made, right?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, nothing's been me.
[CUSTOMER][NEUTRAL] Mhm. And OK. And
[CUSTOMER][NEUTRAL] Uh, this is, uh, annual maximum. How much is that? 500?
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you tell me the group name and the group number?
[CUSTOMER][NEUTRAL] 10.
[AGENT][NEUTRAL] Uh, hold on just a second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] My group name is T as in Tom, R as in Romeo, C as in Charlie, Staffing Services.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Let me see uh the the state of [PII] has been paid.
[CUSTOMER][NEUTRAL] OK, and what's?
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] number is [PII].
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 70055
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Can you tell me the orthodontic age limit?
[AGENT][NEUTRAL] Uh, the age limits are on the facts.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And uh auto is work in progress is applied.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Auto, uh, work in progress is applied.
[CUSTOMER][NEUTRAL] it.
[AGENT][NEUTRAL] But they don't have any ortho benefits, is that what you're asking?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] There there's no ortho.
[CUSTOMER][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] And uh all the, all the procedure codes is over 100%, right?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] So, preventative services pay 100%, radiographs, basic and basic restorative pay 80%.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And me.
[AGENT][NEGATIVE] There's no major coverage.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] OK. And what about in the on periodontics and or surgery?
[AGENT][NEGATIVE] It's not covered.
[CUSTOMER][NEUTRAL] Only um basics and preventative.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And this place is, um, can you tell me the provider is in or out of network?
[AGENT][NEUTRAL] Uh, we don't have access to if you're network. Harrington's the network.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] You need their number?
[CUSTOMER][NEUTRAL] Mm, I have the provider tax ID NPA number and the provider's name.
[AGENT][NEUTRAL] So I mean, do you need the number to Carrington? We don't have access to if you're in network or not, so do you need Carrington's telephone number to see if you're in network?
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mm, no, it's OK. Um.
[CUSTOMER][NEUTRAL] And so, uh,
[CUSTOMER][NEUTRAL] I have uh another question, uh, one other patient. Yeah, uh, please can you give me the order?
[AGENT][NEUTRAL] The reference number, is that what you needed?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] My name is [PII], today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And so, um, I have, uh, one last question. Can you hear me that, please?
[AGENT][NEUTRAL] OK OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The policy number?
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] The same
[CUSTOMER][NEUTRAL] It is 243-74887.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All the information would be the same, that's the same policy?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] She's a patient.
[CUSTOMER][NEUTRAL] Yes, um, and
[CUSTOMER][NEUTRAL] Uh, the patient's name is [PII].
[CUSTOMER][NEUTRAL] And [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, um, everything's the same. Let me look at her history. um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] You can yeah.
[AGENT][NEUTRAL] Um, she had an exam and cleaning on [PII]. She's not used anything for [PII].
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] That's all the history I have.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That you
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, that's all. Thank you so much for your help, [PII], [PII]. So.
[AGENT][NEUTRAL] OK. Anything else I can help with?
[CUSTOMER][NEUTRAL] No, that's all. Thank you for your help. And so, uh, uh, for the last, uh, please can you say that again the group number, the group name, so.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Uh, yes, it was the same as the other one, so it's PRC Staffing Services 70055.
[CUSTOMER][NEUTRAL] Mm, yes. Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Staffing Services, right? S T A F F F I N G.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. Thank you so much for your help, [PII].
[AGENT][POSITIVE] Thank you for calling ATL. Hope you have a good day.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, you too. Bye-bye.
[AGENT][NEUTRAL] OK bye bye