AccountId: 011433970860
ContactId: 3e1448a2-6ec7-416b-9b6c-f4dc60c27365
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 217350 ms
Total Talk Time (AGENT): 104810 ms
Total Talk Time (CUSTOMER): 60855 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/3e1448a2-6ec7-416b-9b6c-f4dc60c27365_20250317T18:06_UTC.wav
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[AGENT][POSITIVE] And thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning. My name is [PII]. I'm calling from [PII] [PII] trying to check eligibility for a patient plan. Could you help me with this?
[AGENT][NEUTRAL] I'm sure, and I can assist you with benefits. Um, first, I'll need to go callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] Yes, it is [PII] [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] It is 0259 8347.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It is [PII] and date of [PII].
[AGENT][NEUTRAL] Thank you and just let me 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 over to you.
[CUSTOMER][NEGATIVE] Um, actually, I requested a fax sign over one hour ago and I didn't receive. That's why I call it again. I'm missing the frequencies and the percentage of cover for the plan of procedure codes.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] His benefits are coming up. One moment.
[CUSTOMER][POSITIVE] Uh thank you.
[AGENT][POSITIVE] Mhm, no problem.
[AGENT][NEUTRAL] OK, yes, ma'am. I'm showing that under this plan, we cover up to $500 per calendar year. That's the benefit maximum, but there is a $50 deductible that needs to be met first.
[AGENT][NEUTRAL] Um, let's see. Preventative is covered at 100% of allowable, and radiographs, basic and basic restorative expenses are already um 80%.
[AGENT][NEUTRAL] The frequencies, I'm showing that cleaning is 1 every 6 months.
[AGENT][NEUTRAL] And then oral evaluations, 2 for 12 month period.
[AGENT][NEUTRAL] Then by wing, there's one per 12 month period.
[AGENT][NEUTRAL] And for full mouth X-ray and panoramics, I'm showing one every 5 years.
[CUSTOMER][NEUTRAL] Got it, um, by any chance can I request again the benefits, the facts for the patient?
[AGENT][NEUTRAL] Yes, ma'am. What's your fax number?
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] OK, so that's attention, [PII], [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. You should receive it in about 10 minutes. I just sent it again.
[CUSTOMER][POSITIVE] Thank you. I really appreciate it and have a great one, take care.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, I think that that's all the in for what I'm looking for today. Thank you.
[AGENT][POSITIVE] Mhm. Thank you again, [PII], for calling APL. You have a great day as well. Mm bye.