AccountId: 011433970860
ContactId: 380bf5e5-3fe9-482d-ad4d-6f1ee42bb577
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202399 ms
Total Talk Time (AGENT): 83087 ms
Total Talk Time (CUSTOMER): 40111 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/380bf5e5-3fe9-482d-ad4d-6f1ee42bb577_20250317T17:54_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I was calling to ask a few questions, questions about a patient's eligibility and benefits.
[AGENT][NEUTRAL] I can help with eligibility and benefits, and with whom am I speaking, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], thank you. And what is that, uh, policy number, please?
[CUSTOMER][NEUTRAL] 616-994.
[AGENT][NEUTRAL] And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] and her date of birth is [PII].
[AGENT][POSITIVE] Great. Well, I'm looking that up, please, if I could just have a callback number in the event that we're disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you very much. Uh, the policy went into effect on [PII]. It is active. Now you mentioned wanting to know about the benefits. Uh, these policies have $1000 per calendar year as the maximum, and that's just a verification of the benefits, not a guarantee of payment.
[AGENT][POSITIVE] And it pays a flat rate benefit for the surfaces that are covered.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, and how much is remaining from the maximum?
[AGENT][NEUTRAL] The calendar year [PII], let's see.
[AGENT][NEGATIVE] It looks like uh neither member have used any of their benefits at all.
[CUSTOMER][NEUTRAL] OK. And then, uh,
[CUSTOMER][NEUTRAL] Is the patient eligible for a pano?
[AGENT][NEUTRAL] Well, let's just check, see.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] I don't see that one's been done recently. I'm just checking.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] It doesn't look like one has been done.
[AGENT][NEUTRAL] In the past 5 years.
[CUSTOMER][NEUTRAL] OK. And
[CUSTOMER][NEUTRAL] OK, and then are they eligible for um an exam or proy or bye wings as well?
[AGENT][NEUTRAL] Oh it's
[AGENT][NEUTRAL] OK, now, [PII] just had one had the trophy down on [PII].
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And bite wings as well. So the bite wings are once for uh 12 month period. Uh, see.
[AGENT][NEUTRAL] And uh [PII], the last time that she had uh
[AGENT][NEUTRAL] cleaning was in [PII], so she would be eligible for the cleaning, the examinations, the, uh, the by wings.
[CUSTOMER][POSITIVE] Perfect thank you so much that's all the questions I have today.
[AGENT][POSITIVE] OK, thanks for contacting UPI.