AccountId: 011433970860
ContactId: a36eb2b9-66c7-44e0-affe-95f2a82e233f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 278779 ms
Total Talk Time (AGENT): 123209 ms
Total Talk Time (CUSTOMER): 102358 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.4, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/a36eb2b9-66c7-44e0-affe-95f2a82e233f_20250318T16:57_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Contacting ATL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling because I have a patient. I need to check their eligibility and a breakdown of their benefits. Would you be able to help me with that?
[AGENT][NEUTRAL] Yes, I can help with eligibility and benefits. [PII], what's the policy number, please?
[CUSTOMER][NEUTRAL] Yes, I have 02598347.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's gonna be [PII] and date of birth is [PII].
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yes, my direct number is gonna be [PII].
[AGENT][NEUTRAL] Thank you. It looks like the policy went into effect on [PII]. It is active. Now, these policies have $500 per calendar year as the maximum. That's just verification of the benefits, not a guarantee of payment, and it covers basic, basic restorative and preventative services only. Is there anything in particular that I can tell you about this limited benefit dental policy?
[CUSTOMER][NEUTRAL] Yes, is there also benefits in this plan?
[AGENT][NEGATIVE] Uh, no, there are no orthodontic benefits.
[CUSTOMER][POSITIVE] Thank you. Is there any missing two calls?
[AGENT][NEUTRAL] Yes, there is.
[CUSTOMER][NEUTRAL] Is there a waiting period?
[AGENT][NEUTRAL] Uh, no, ma'am, there is not.
[CUSTOMER][POSITIVE] Thank you. And there's no deductible or family deductible?
[AGENT][NEUTRAL] There is a $50 deductible that does not apply to the preventative services, and the family deductible is $150.
[CUSTOMER][NEUTRAL] Thank you and then what is the um the percentages for preventive and basic?
[AGENT][NEUTRAL] Uh, the preventative is covered at 100% of the allowable and basic and basic restorative are at 80%. There's no major, uh, uh, um, procedures for this. No endodontics, no periodontal services, no oral surgery.
[CUSTOMER][NEUTRAL] OK, no oral surgery and then um.
[CUSTOMER][NEUTRAL] The prodonic you said it's not covered either, correct?
[AGENT][NEGATIVE] Uh, no, it is not.
[CUSTOMER][NEUTRAL] OK and then what is um if I give you some of the frequencies can you um tell me if you guys provide those?
[AGENT][NEUTRAL] Yes, and what is the first one?
[CUSTOMER][NEUTRAL] Is 0120.
[AGENT][NEUTRAL] Uh, yes, now that is uh 2 per calendar year and that includes all of the evaluations. 120, 130, 140, 150, any of the, the evaluations that's due for per 12 month period.
[CUSTOMER][NEUTRAL] Thank you and then I also have um 0274.
[AGENT][NEUTRAL] Uh yes, the bite wings are once for 12 month period.
[CUSTOMER][NEUTRAL] OK, and then 0330?
[AGENT][NEUTRAL] Uh, the, um, full mouth and panel are once every 5.
[CUSTOMER][POSITIVE] Thank you 11:10.
[AGENT][NEUTRAL] That is uh 1 for 6 month period.
[CUSTOMER][POSITIVE] Thank you 2391.
[AGENT][NEUTRAL] Uh, for the, um, uh.
[AGENT][NEUTRAL] The fillings that is uh one for 24 months and they must be in place for 24 months for replacement.
[CUSTOMER][NEUTRAL] Thank you. And then our fillings downgraded to Elm again?
[AGENT][NEGATIVE] Uh, no, they're not.
[CUSTOMER][NEUTRAL] Thank you and then 4341?
[AGENT][NEGATIVE] But that is not covered.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] And then um let me see what else I need that would be it and then just to confirm the group name is Group Voluntary Dental?
[AGENT][NEUTRAL] Yes, so it's American Public Life is the name of the, of the dental.
[CUSTOMER][POSITIVE] Thank you and then for the group number I have 70072.
[AGENT][NEUTRAL] Let's see.
[AGENT][POSITIVE] 70072. That is correct.
[CUSTOMER][POSITIVE] Perfect, can I just get a reference number for this call, please?
[AGENT][NEUTRAL] My name is [PII]. The first letter of my last name is [PII], and we're gonna use that today's date as a reference. Is there anything else at all that I can help with?
[CUSTOMER][POSITIVE] No, that is it, Ms. [PII]. Thank you so much. Have a good day.
[AGENT][POSITIVE] OK, thanks for contacting APR.
[CUSTOMER][NEUTRAL] Bye bye.