AccountId: 011433970860
ContactId: 7ee92df3-e832-440b-adbf-4078ef02e987
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210289 ms
Total Talk Time (AGENT): 107782 ms
Total Talk Time (CUSTOMER): 61187 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/7ee92df3-e832-440b-adbf-4078ef02e987_20250212T16:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII]. I'm calling from Cedar Hill Modern Dentistry, and I'm calling to check on a patient's benefits.
[AGENT][NEUTRAL] OK, I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] 02569305.
[AGENT][POSITIVE] And a good call back number in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh first name is [PII], last name [PII].
[AGENT][NEUTRAL] And date of birth.
[CUSTOMER][NEUTRAL] Oh yes, uh [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And thank you for verifying that information, [PII]. Let's see, we're looking for eligibility and then dental benefit, dental benefits.
[CUSTOMER][POSITIVE] Yes, please, yes.
[AGENT][NEUTRAL] Would you like to schedule um faxed over to you?
[CUSTOMER][POSITIVE] Yes, that would be great. Um, my number is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I will give you the policy effective date which is [PII]. Um, I show this policy is active at this time.
[AGENT][NEUTRAL] And uh
[AGENT][NEGATIVE] There is no history uh for this patient.
[AGENT][NEUTRAL] And I do show that the maximum benefit per calendar year is 1,500 $50 deductible individual policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on the schedule of benefits.
[AGENT][NEUTRAL] It will list the calendar, your max deductible information. The effective date is on there as well. Um, it'll pro provide the category of expense. Um, there is a 12 month waiting period for major.
[CUSTOMER][NEUTRAL] Early morning
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, you had a list of frequencies, uh, the common limitations exclusions, um, the payer ID, claims, mailing address and fax number, and each procedure code that's covered under the policy and its limitations, um, so it's gonna be about 9 pages maybe with the cover sheet that you're gonna be getting and I have already sent it over to you so you should receive it within about 5 minutes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you, quick question, what is the group number?
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] I can get that for you.
[AGENT][NEUTRAL] Um, the group number is 17626.
[CUSTOMER][NEUTRAL] Oh, tell me it's 626.
[AGENT][NEUTRAL] Mhm. It's 17.
[AGENT][NEUTRAL] 626.
[CUSTOMER][NEUTRAL] 0 626 OK and then is does this go through a fee schedule?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] There is no network of uh contracted providers for this policy so it does not.
[CUSTOMER][NEUTRAL] It goes through UCR.
[AGENT][NEUTRAL] Yes, which is notated on the schedule. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome well I appreciate that so much have a great day.
[AGENT][POSITIVE] You're welcome, [PII]. If no further questions, thanks for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Alrighty bye bye.
[AGENT][NEUTRAL] Bye bye.