AccountId: 011433970860
ContactId: 6de6c883-5ad9-4350-af74-411f661bc726
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 175830 ms
Total Talk Time (AGENT): 86672 ms
Total Talk Time (CUSTOMER): 64608 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/6de6c883-5ad9-4350-af74-411f661bc726_20250106T20:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good afternoon [PII]. My name is [PII]. I'm calling with, um, at, at a provider's office. I just had a few questions regarding about a patient's benefits.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, yeah, I can check benefits for you, [PII]. um, can I get a good
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Callback number from me first in case we're disconnected please.
[CUSTOMER][NEUTRAL] Yeah, uh [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, it's going to be 02.
[CUSTOMER][NEUTRAL] 36 1985.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, uh, what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that with it. Uh, so this policy is active. Effective date was [PII], and you said you had questions about the benefits?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, um, does he have a missing tooth calls or any waiting periods?
[AGENT][NEUTRAL] Um, let me get this pulled up and then um if you don't already.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I can send you a fax back showing all of the covered procedures and benefits.
[AGENT][NEUTRAL] The Information
[CUSTOMER][POSITIVE] Oh no, I just had 4 questions. It's OK, thank you.
[AGENT][NEUTRAL] Sure, OK, of course, let me get it pulled up here give me just a moment.
[AGENT][NEUTRAL] Alright, and of course I will let you know verification of coverage is not a guarantee of payment for claims, so it does have a missing tooth clause and as for waiting periods, um, yes, for.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's 12 month waiting period for a major endodontic periodontic oral surgery. Um, but of course since the effective date was [PII], he should be fine.
[CUSTOMER][NEUTRAL] OK, so no waiting periods for him at this moment?
[AGENT][NEUTRAL] Yeah, right, right.
[CUSTOMER][POSITIVE] Perfect and then um did he use any of the annual maximum?
[CUSTOMER][NEUTRAL] This year?
[AGENT][NEUTRAL] Let me double check. This is a per calendar year. Let me see. Oh my goodness, almost 2024. No, none has been used so far this year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect and then so he still has the 1500.
[AGENT][NEUTRAL] Correct, and then the $50 deductible and it does not apply to preventative expenses.
[CUSTOMER][POSITIVE] Perfect and that is still, it hasn't been met yet then?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Perfect, um, and then that that was all thank you.
[AGENT][NEUTRAL] OK, yeah. Did you have any other questions for me?
[CUSTOMER][POSITIVE] No, that was all thank you so much.
[AGENT][POSITIVE] Alright, yeah, thanks for calling ATL. Have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you you too bye.
[AGENT][POSITIVE] Thank you bye bye.