AccountId: 011433970860
ContactId: 6c6c68e6-f444-48d2-8c2e-b20f8957664a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 231669 ms
Total Talk Time (AGENT): 83398 ms
Total Talk Time (CUSTOMER): 76947 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/2025/05/20/6c6c68e6-f444-48d2-8c2e-b20f8957664a_20250520T15:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I needed to get a claim payer ID number for a patient.
[AGENT][NEUTRAL] Sure, our payer ID is 60801.
[CUSTOMER][NEUTRAL] 60801
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK and the address she gave me was [PII] I'm sorry [PII] [PII].
[AGENT][NEUTRAL] That's correct, um, we've also got a fax number if you'd like that as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, and I was also wondering if her deductible is gonna apply to diagnostic.
[AGENT][NEUTRAL] I can get that policy pulled up and take a look. Was this for um dental?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so deductibles do not apply to preventative expenses.
[CUSTOMER][NEUTRAL] OK, so, um, she had no frequency on our FMX 80% of allowable fees, no deductible?
[AGENT][NEUTRAL] Let me get the policy pulled up to be sure. Most of the time FMX does have a frequency of once per 5 years, um, so let me get that information. I'm so sorry, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then before we go any further, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. Do you have that policy number?
[CUSTOMER][NEUTRAL] I'm getting it pulled back up. I gotta get into her husband's chart.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] It is 02623675.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII], it is [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying that. OK, so of course this policy is active. Effective date was [PII]. Give me just a moment, let me get that pulled up.
[AGENT][NEUTRAL] OK, and of course I will let you know verification of coverage is not a guarantee of payment for claims. So yes, this deductible, the $50 deductible, does not apply to preventative services. Uh, frequency for full mouth X-rays and panel is once every 5 years.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, so 80% of allowable fees, no deductible.
[AGENT][NEUTRAL] 80% of allowable for um FMX and basic uh preventative is at 100.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] That'll be it.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right. Well, thanks for giving us a call, [PII]. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.