AccountId: 011433970860
ContactId: 57fe0bee-c005-4dc2-b35e-990e70a2238c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 234880 ms
Total Talk Time (AGENT): 128664 ms
Total Talk Time (CUSTOMER): 91017 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/57fe0bee-c005-4dc2-b35e-990e70a2238c_20250106T19:02_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, this is [PII]. I'm calling from provider's office and I was wondering if you could help me with some benefits on the patient.
[AGENT][NEUTRAL] I can help with benefits. [PII]. What's that policy number we're looking at today?
[CUSTOMER][NEUTRAL] 00612428
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] So [PII] [PII].
[AGENT][POSITIVE] I do appreciate that. If I can have a callback number please, the that we're disconnected.
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[AGENT][NEUTRAL] Thank you very much. It looks like her policy went into effect on [PII]. It is current. Now, you mentioned wanting to know about the benefits, um.
[AGENT][NEUTRAL] These policies have $1000 for calendar year a maximum. Uh, that's just uh verification of benefits, not.
[AGENT][NEUTRAL] A guarantee of payment.
[AGENT][NEUTRAL] Now, is there anything in particular that I could tell you I uh what what it pays out or?
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Yeah, like oral surgery, impacted teeth and sedation. How does that cover?
[AGENT][NEUTRAL] OK, so what we do, it pays a flat rate benefit and I do have a, a, a printout that I can send to you, but if you'll give me a code, I can give you an idea of what, of what the cost would be.
[CUSTOMER][NEUTRAL] OK, um, 7240.
[AGENT][NEUTRAL] OK, let me just check here really quickly.
[AGENT][NEUTRAL] OK. So, uh, an impacted tooth uh that uh we would pay a flat rate of $85. It's just a verification of benefits, not a guarantee of payment. And you said that there was sedation as well?
[CUSTOMER][NEUTRAL] Yes ma'am, that's um 9223 or 9222.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So, uh, that would be approximately $41. Um, again, just the verification of benefits, not a guarantee of payment, but that's what the policy does. It pays a flat rate benefit for for those services.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right, OK, um, now that the sibling, I have a sibling, [PII], she's on that policy too. Do both of them, do they have a deductible? I meant to ask you that on [PII].
[AGENT][NEUTRAL] Yes, the policy does have a $50 deductible that does not apply to the primary, um, excuse me, to the, uh, um, preventative services. So if someone was having a tooth removed that $50 would be due. Now as far as um.
[AGENT][NEUTRAL] Whether that has been paid for the calendar year [PII].
[AGENT][NEUTRAL] [PII] or [PII], it doesn't look like it has been, so that would be due.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and this is a calendar year?
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] Policy, OK, great, great, great, um.
[CUSTOMER][NEUTRAL] Alright, flat rate. Let me write that on her I'll forget by the time we hang up.
[CUSTOMER][NEUTRAL] Alright, good deal, and this doesn't go as a secondary, right? I mean it it's just a regular insurance because we do it as the um we go by the date of birth, you know, with a family member.
[CUSTOMER][NEUTRAL] Um, I just wanna make sure this is not some kind of secondary that we're putting it in here while we got as primary.
[CUSTOMER][NEUTRAL] Do y'all usually file it like that or is it a, you had to file a secondary?
[AGENT][NEUTRAL] Well, we don't, we don't actually, um, we don't know whether they have another um benefit or not, another policy or not.
[CUSTOMER][POSITIVE] I got you.
[CUSTOMER][NEUTRAL] You're gonna pay it that way either way, right? if they have another policy or not? OK, good deal. That's what I need to know and can I get your name again?
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] My name is [PII]. The first letter of my last name is [PII], and we're gonna use that in today's date as a reference. [PII], is there anything else at all I can help with?
[CUSTOMER][POSITIVE] Sounds great.
[CUSTOMER][POSITIVE] No ma'am thank you you have a good day.
[AGENT][POSITIVE] OK, thanks for contacting AP have a good day.