AccountId: 011433970860
ContactId: 4aae544b-8618-4aa7-b6d1-39bd5c5b9c52
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 509109 ms
Total Talk Time (AGENT): 238104 ms
Total Talk Time (CUSTOMER): 108526 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/4aae544b-8618-4aa7-b6d1-39bd5c5b9c52_20250512T17:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi I was calling about uh what exactly my benefits are with my dental insurance.
[AGENT][NEUTRAL] OK, I can help you with dental benefits. May I please get your name and your call back number?
[CUSTOMER][NEUTRAL] My name and what number?
[AGENT][NEUTRAL] Your call back number?
[CUSTOMER][NEUTRAL] Uh, my name is [PII].
[CUSTOMER][NEUTRAL] And my callback number would be [PII].
[AGENT][NEUTRAL] OK thank you Ty and what is your uh policy number?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] 249-4906
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, Ty, can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you sir and then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Uh, my address is [PII].
[CUSTOMER][NEUTRAL] And you want my email?
[AGENT][NEUTRAL] Your email and um your phone number on file.
[CUSTOMER][NEUTRAL] Uh, email is [PII].
[CUSTOMER][NEUTRAL] And then phone number is [PII].
[AGENT][POSITIVE] Thank you. I appreciate you verifying that information for me, Ty. OK, let's look real quick and you're trying to get benefit information.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, let me pull up your benefits real quick.
[CUSTOMER][NEUTRAL] All right
[AGENT][NEUTRAL] It's gonna be just a second while I pull in your benefits. I didn't want you to think I forgot about you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is just to verify your benefits. It's not a guarantee of payment. You have a calendar year maximum benefit amount of $1500 with a $50 co-pay, I mean, sorry, uh, deductible.
[CUSTOMER][NEUTRAL] $1500.
[AGENT][NEUTRAL] Yes, per calendar year.
[AGENT][NEUTRAL] And then you have a $50 deductible.
[CUSTOMER][NEUTRAL] OK, so what's that $1500 go to like whatever like they did an extraction or something?
[AGENT][NEUTRAL] Uh, it depends on what the procedure code is.
[AGENT][NEUTRAL] Um, you have a preventative, and this is just to verify your benefits. It's not a guarantee of payment. You have preventative radiographs, basic expenses, and major expenses. Um, so it's all based on what they send in.
[AGENT][NEUTRAL] With the procedure codes on how it's paid and what amount is paid, if they need to verify your benefits with us before they work on you, they can do that they could call the same number you did and they can give us the codes and we can tell them how it pays.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But just an overview.
[CUSTOMER][NEUTRAL] OK, goodbye.
[AGENT][NEUTRAL] Overview for you, um, your preventative expenses are paid 100%.
[AGENT][NEUTRAL] Your radiographs, basic and basic restorative are paid 80%.
[AGENT][NEUTRAL] Your major.
[CUSTOMER][NEUTRAL] Preventative is 100%.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Restorative is 80%.
[AGENT][NEUTRAL] Your
[AGENT][NEUTRAL] Yeah, your basic is paid 80% and your major expenses are paid at 40%.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And major expenses are 40%.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And you get um cleanings once every 6 months.
[CUSTOMER][NEUTRAL] every 6 months.
[AGENT][NEUTRAL] You get
[AGENT][NEUTRAL] Yes, and you can get your exams 2 for 12 month period.
[AGENT][NEUTRAL] Your bite wing um X-rays that they give you are once every 12 months.
[AGENT][NEUTRAL] And full mouth X-rays are once every 5 years.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you need crowns or bridges,
[AGENT][NEUTRAL] Partials or dentures, crowns or bridges are once every 7 years and partial and dentures are once every 5 years.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] That's
[CUSTOMER][NEUTRAL] 85 years.
[AGENT][NEUTRAL] Yeah that's basically it in a nutshell without having the procedure code that they're actually going to do.
[CUSTOMER][NEUTRAL] Alright well.
[CUSTOMER][NEUTRAL] OK, well, I, uh, I called the dentist and um.
[CUSTOMER][NEUTRAL] But so I have a toothache that I'm trying to get them to look at and they said it was gonna be I had, I was gonna have to pay $50 for deductible and.
[CUSTOMER][NEUTRAL] Uh, 60% of whatever it would cost like if I did an extraction or something.
[AGENT][NEUTRAL] OK. Did they call and get your benefits with us?
[CUSTOMER][NEUTRAL] Is that done right?
[CUSTOMER][NEUTRAL] They said they did.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, unless we have a procedure code I, I can't give you a complete amount but those benefits that I just gave you are are based.
[AGENT][NEUTRAL] You know, the percentage of your coverage.
[AGENT][NEUTRAL] They would have to give us a procedure code so that we could look and see exactly if it falls under basic preventative or major.
[CUSTOMER][NEUTRAL] OK, that procedure code would have to be done after I get my thing done or right whenever they figure out what I need.
[AGENT][NEUTRAL] Well no if they know what you need, they can call and give us the procedure codes and we can look them up.
[AGENT][NEUTRAL] Or send them, we can send them your benefits also and they can look it up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, I will, uh, go and do that and then I'll have him send that to you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] And I hope you get everything worked out with your tooth. I know it hurts to have a tooth.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][MIXED] It is rough, but ibuprofen's fighting it.
[AGENT][NEUTRAL] Well, at least you can take ibuprofen for now anyway, until you get it fixed.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] But uh alright well I thank you ma'am.
[AGENT][POSITIVE] You're very welcome. I hope you have a wonderful day, Ty, and thank you for calling ATL.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Mhm. Bye-bye, sir.