AccountId: 011433970860
ContactId: 415d881a-924c-4b85-8117-9825368873df
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 583590 ms
Total Talk Time (AGENT): 101124 ms
Total Talk Time (CUSTOMER): 90322 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/415d881a-924c-4b85-8117-9825368873df_20250124T13:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hey, good morning. This is [PII] from Dental provider's office. How are you doing?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][POSITIVE] I'm fine, thank you for asking. I have just one patient with few questions regarding the dental benefits, and I need your help.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with benefits. Um, first, I'll need a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] Uh-huh. Uh, it's [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] 02566124.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, patient is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK. Yes, sir. And how can I help you?
[CUSTOMER][NEUTRAL] So is this the plan with the group number 24313?
[AGENT][NEUTRAL] Let me see, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, that's the group number.
[CUSTOMER][NEUTRAL] OK, so just help me with the used amount from the annual maximum and deductible.
[AGENT][NEUTRAL] OK. One moment.
[AGENT][NEUTRAL] Um, so far, nothing has been used. It's all available.
[CUSTOMER][NEUTRAL] OK, and uh I have 5 procedure codes. I just need percentage and the frequency.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. What's the first code?
[CUSTOMER][NEUTRAL] 0367.
[AGENT][NEUTRAL] OK, thanks for your patience. I'm still waiting on my system.
[CUSTOMER][POSITIVE] Mhm take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] You said the code was 0367?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Corned bean
[AGENT][NEUTRAL] OK. And what is the procedure called again?
[CUSTOMER][NEUTRAL] 0367.
[AGENT][NEUTRAL] And what type of service is it?
[CUSTOMER][NEUTRAL] Is this conebeam CT, uh, type of X-ray.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, that code is not coming up on the list, but for X-ray procedures, there's a limit of one bite wing X-ray procedure and the codes are 270, 272, and 274 per twelve-month period.
[CUSTOMER][NEUTRAL] Mhm OK, that's fine. Uh, we can skip to the next call. It's um 0431.
[AGENT][NEUTRAL] And for what type of service is this for?
[CUSTOMER][NEUTRAL] Uh, oral cancer screening.
[AGENT][NEUTRAL] OK, for screenings, we cover up to 2 per 12 month period. So 2 per calendar year.
[CUSTOMER][POSITIVE] And uh covered at 100%.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, uh, next we have 0470.
[AGENT][NEUTRAL] And for what type of procedure?
[CUSTOMER][NEUTRAL] Uh, it's a diagnostic cast.
[AGENT][NEUTRAL] OK, that's covered up to 80% UCR.
[AGENT][NEUTRAL] And no waiting period.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, uh, next we have 0801 3D scan.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's also covered up to 80% UCR and no waiting period.
[CUSTOMER][NEUTRAL] Mhm. And last procedure code, um.
[CUSTOMER][NEUTRAL] 1330 oral hygiene instruction OHI.
[AGENT][NEUTRAL] OK, 80% with no waiting period.
[CUSTOMER][NEUTRAL] Uh sorry, what did you say? I didn't catch that.
[AGENT][NEUTRAL] Um, 80%.
[AGENT][NEUTRAL] USR with no waiting period.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] That's, that's all, and uh, what's the reference number and please spell it out your name once.
[AGENT][NEUTRAL] Um, yes, for the reference number, you can use my name and today's date. My name is [PII]. It's spelled [PII] Last initial is [PII], and today's date. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] Uh, no, I, that's all, and thank you so much for your help.
[AGENT][POSITIVE] OK. Thank you, [PII], for calling ATL. You have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] Bye now.