AccountId: 011433970860
ContactId: 7debd7e4-2b9c-4721-a200-1a04afc7557f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 216270 ms
Total Talk Time (AGENT): 80982 ms
Total Talk Time (CUSTOMER): 78166 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/7debd7e4-2b9c-4721-a200-1a04afc7557f_20250227T19:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I'm calling to receive patient history.
[AGENT][NEUTRAL] OK, I can assist with that and may I have your call back number please if disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you and what is that policy number, please?
[CUSTOMER][NEUTRAL] 02367353
[AGENT][NEUTRAL] OK, I have that as 02367353. 1 moment please, and may I have your name again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] [PII], OK, thank you.
[AGENT][NEUTRAL] And verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you very much for the verification process and again you're calling for history for the patient, correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, I can certainly help you with that. um, she has no history at all on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][MIXED] And um I do have benefits from last year. I just wanna make sure they changed. I have preventative at 100 basic at 80, which only covers fillings. Everything else is not covered.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] It covers fillings and a simple tooth extraction.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is orthodontic still not covered?
[AGENT][MIXED] That is correct, it is not covered.
[CUSTOMER][NEUTRAL] As for fillings or molar tea, do they downgrade?
[AGENT][POSITIVE] There are no downgrades at all in the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, can you confirm with me for panels and periodicals, are they under basic or major?
[AGENT][NEGATIVE] They're on the there's no major coverage they're on the basic.
[CUSTOMER][NEUTRAL] I'm sorry, um, OK, basically, yes.
[CUSTOMER][NEUTRAL] And then for code 0140 limited exam, can treatment be done on the same day?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It does not state
[CUSTOMER][NEUTRAL] OK. Is the specialty exam covered 0160?
[AGENT][NEUTRAL] 0160, 1 moment.
[AGENT][NEUTRAL] That is covered under basic at 80% and that frequency one moment just to make sure.
[AGENT][NEUTRAL] And it's 2 for 12 month period.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does it run in the calendar year plan or plan year?
[AGENT][NEUTRAL] This is a calendar year policy.
[CUSTOMER][NEUTRAL] As for the maximum, I have 500 and deductible 50, family deductible 250, has anything changed?
[AGENT][NEUTRAL] I'm sorry, the max is 500, the deductible is 50 per individual is up to $150 for the family.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Gotcha.
[CUSTOMER][NEUTRAL] And she has the full remaining 500.
[AGENT][NEGATIVE] Nothing has been met. Um, she hasn't met her deductible as well.
[AGENT][NEUTRAL] For this year she's not used the policy at all.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. The group name and group number, is that ATC Healthcare 70069?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you, [PII]. Can I have a reference number?
[AGENT][NEUTRAL] You're welcome, [PII]. We do not use reference numbers, but you can use my name and today's date. Last initial is [PII]. Anything else I can help you with, [PII]?
[CUSTOMER][POSITIVE] Might as well. Thank you.
[AGENT][POSITIVE] Thank you for calling AP have a good day. mm bye.
[CUSTOMER][NEUTRAL] Bye bye.