AccountId: 011433970860
ContactId: 68537a76-2b92-475f-a2d3-5bdd183d14fb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167789 ms
Total Talk Time (AGENT): 85172 ms
Total Talk Time (CUSTOMER): 67778 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/68537a76-2b92-475f-a2d3-5bdd183d14fb_20241230T15:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] This is [PII] with Nettleton Dental. I need a, a brief breakdown of benefits for a patient of ours who has your insurance.
[AGENT][NEUTRAL] OK, and what's your name, ma'am?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. And what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] 02569606
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, and you said that you're needing benefit information?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Is this in a doctor's office or an outpatient, uh, facility hospital setting?
[CUSTOMER][NEUTRAL] This is a dental office.
[AGENT][POSITIVE] Oh, dental. OK, thank you.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And verify the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh, [PII], date of birth [PII].
[AGENT][POSITIVE] Thank you for that and would you, let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Would you like to schedule a benefits faxed to your office?
[CUSTOMER][POSITIVE] Yes ma'am, that'll be fine.
[AGENT][NEUTRAL] And what is that fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and would you like to know what information is included on the schedule?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so I'll first start by saying there is no claims history for this uh patient.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] The schedule of benefits will include, of course, his name, his policy number, effective date.
[AGENT][NEUTRAL] It'll provide the calendar your maximum and deductible information.
[AGENT][NEUTRAL] Uh, it covers preventive and basic and uh preventive at 100% basic at 80 major is not covered, so you won't see any major codes on it. Um, it will provide the.
[CUSTOMER][NEUTRAL] OK, is, uh, what does endo and Perio come under basic or major, major.
[AGENT][NEUTRAL] It's, it's, it's major. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and what is the max?
[AGENT][NEUTRAL] The max is $500 per calendar year and then deductible is $50 per person. This is an individual policy.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Does the deductible come towards preventive?
[AGENT][MIXED] It does. Well, not deductible, it applies towards basic only.
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] But it is included in the maximum benefit.
[CUSTOMER][NEUTRAL] OK, well I.
[CUSTOMER][NEUTRAL] OK, and 500 is the max, OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, I'll be waiting on the fact, but I can get started on this.
[AGENT][NEUTRAL] OK. All [PII]. Well, you should receive it within the next 5 to 7 minutes, [PII], did you have any other questions?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No ma'am that's all.
[AGENT][POSITIVE] Alright, thanks for calling ATL have a good day.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.