AccountId: 011433970860
ContactId: 6454c480-5609-41dd-83a0-849e30e2e885
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 297799 ms
Total Talk Time (AGENT): 100248 ms
Total Talk Time (CUSTOMER): 128013 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/6454c480-5609-41dd-83a0-849e30e2e885_20250218T19:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good afternoon, [PII]. This is [PII] with Timmons Dental. How are you?
[AGENT][POSITIVE] I'm good, [PII]. How about yourself today?
[CUSTOMER][NEUTRAL] Good, I have some questions about a patient's policy please.
[AGENT][NEUTRAL] OK, let's take a look. What is the patient's policy number?
[CUSTOMER][NEUTRAL] 02594869
[AGENT][POSITIVE] Alright, thank you, let me pull this up.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And do you spell your name [PII] or [PII]?
[AGENT][NEUTRAL] Um, I have an [PII] at the end.
[CUSTOMER][POSITIVE] Perfect thank you.
[AGENT][NEUTRAL] No problem, [PII] and then if I can get the patient name and date of birth?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Alright, thank you so much.
[AGENT][NEUTRAL] Patient is active. The effective date on the policy is gonna be [PII].
[AGENT][POSITIVE] And then if you need us to we can also send a breakdown um with a fax back. I'm happy to go over whatever you need to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I did, I got a fax back, um, I just need to kind of clarify some things that I didn't see on the fax back, um, so the policy is just for preventative and basic, no major coverage, correct?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Correct, yes ma'am.
[CUSTOMER][NEUTRAL] OK and then um there is no waiting periods for his basic?
[AGENT][POSITIVE] Correct, yes ma'am.
[CUSTOMER][NEUTRAL] OK, and then if the code is not listed on that fax right that you sent to me, does that mean that it falls under major and it's not a covered code?
[AGENT][POSITIVE] That would be correct, yes ma'am.
[CUSTOMER][NEUTRAL] So no [PII] is covered for his plan.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Perfect, um, and then let me just clarify, um, is his preventative included in that maximum?
[AGENT][NEUTRAL] Uh, yes, it is. It looks like preventative is just not applied towards deductible.
[CUSTOMER][NEUTRAL] Perfect. OK and then is this a calendar year policy or a benefit year?
[AGENT][NEUTRAL] Calendar year.
[CUSTOMER][NEUTRAL] So it does run from January to December.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, and then the fluoride that you have listed, um, the codes that we have is 1206 and 1208, and I didn't see either one of those listed. Does that mean that this fluoride's not covered?
[AGENT][NEGATIVE] Yeah, if it's not on there, it's not, yeah, not covered, if it's not listed, it's not covered, sorry.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] No, you're OK.
[CUSTOMER][NEUTRAL] And then let me just double check and then there was no employer or group name and group number on the fax back.
[AGENT][POSITIVE] Oh, yeah, I can get that for you. Let's take a look.
[CUSTOMER][NEUTRAL] Or at least I didn't see it.
[AGENT][NEUTRAL] OK, so the group number is going to be 70056.
[CUSTOMER][NEUTRAL] 70056.
[AGENT][NEUTRAL] Mhm and the name is management analysis analysis and utilization.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let's see here.
[CUSTOMER][NEUTRAL] You said analysis?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, and since, um, he doesn't have any major, I guess it doesn't need to know if you guys pay on prep date or seat date. Uh, what about do you downgrade posterior composites?
[AGENT][NEUTRAL] Hmm, no downgrade.
[CUSTOMER][POSITIVE] For the filling, no downgrades.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I think that actually may be it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have a reference number for the call?
[AGENT][NEUTRAL] Absolutely. Call reference is my name with my last initial and then today's date. My name again is [PII], which is [PII] is [PII].
[CUSTOMER][POSITIVE] Perfect. OK, thank you so much sir you have a wonderful day.
[AGENT][NEUTRAL] You too [PII]. bye bye.