AccountId: 011433970860
ContactId: 4b79b332-79e1-4175-859a-84ef95356078
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243449 ms
Total Talk Time (AGENT): 50808 ms
Total Talk Time (CUSTOMER): 90577 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/4b79b332-79e1-4175-859a-84ef95356078_20250203T20:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I just wanted to check in on a particular policy for a patient.
[AGENT][POSITIVE] Um, yes, ma'am. I can assist you with benefits. Um, first, I'll need your name and a good callback number.
[CUSTOMER][NEUTRAL] OK, it's [PII] [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number, please?
[CUSTOMER][NEUTRAL] OK, 02578866.
[AGENT][NEUTRAL] And please repeat that policy number?
[CUSTOMER][NEUTRAL] 02587866
[AGENT][NEUTRAL] OK. Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] OK, [PII] um sorry, it's [PII], date of birth [PII].
[AGENT][NEUTRAL] OK. And just let me advise you that verification of coverage does not guarantee payment of claims. Um, I'm showing the effective date on this policy was [PII] and the policy is still active. And for the fee schedule and a list of all the benefits, I can fax that over to you.
[CUSTOMER][NEUTRAL] Um, I did get that. I just wanted to verify whether he has met his waiting period or if that starts over each year.
[AGENT][NEUTRAL] It's per calendar year.
[CUSTOMER][NEUTRAL] Oh, OK, so if he needs a crown, it's got 12 month waiting period on his.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, um, just making sure because under the limitations it only says AA and DD which is 1 in 7 years and a patient over [PII].
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Could I give you the code just to verify?
[AGENT][NEUTRAL] Yes, ma'am. What's that called?
[CUSTOMER][NEUTRAL] It it's D 2740.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Get that.
[CUSTOMER][NEUTRAL] Hey, I talking about that patient, yeah, I'm on the phone with his insurance company.
[CUSTOMER][NEUTRAL] Just wanted to verify the waiting period or not because it says 12 months on here and then over here it didn't so I just wanted to speak to a representative.
[CUSTOMER][NEGATIVE] Restoration will not work here
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][POSITIVE] Sounds good.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because I renewed it last week
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] I gotta get another frame.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh wait.
[CUSTOMER][NEUTRAL] Excuse me.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Were you still checking?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that's why I was confused because I was like, wait, I only see the limitation as AA and DD but not 12 month waiting period, but I know that it is considered a major, so I just wanted to make sure.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, yes, ma'am, and that's correct. That's a 12-month waiting period.
[CUSTOMER][POSITIVE] Oh OK, I just wanted to check. Thank you so much.
[AGENT][POSITIVE] Yeah, thank you for calling ATL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] You too thanks so much bye bye.