AccountId: 011433970860
ContactId: aff6fdd0-2453-4ab1-81be-309a2b60b9c3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 211600 ms
Total Talk Time (AGENT): 91598 ms
Total Talk Time (CUSTOMER): 55357 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/aff6fdd0-2453-4ab1-81be-309a2b60b9c3_20250121T14:05_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I'd like assistance with eligibility for a patient.
[AGENT][NEUTRAL] Sure, I can assist you with that. Could you provide me with the spelling of your name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Can I have a call back number for you and a policy number?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And what is the policy number, [PII]?
[CUSTOMER][NEUTRAL] It's 02483963.
[AGENT][NEUTRAL] Verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, it's [PII] and date of birth is [PII].
[AGENT][NEUTRAL] You're calling to verify benefits and eligibility.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII]'s policy has been active since [PII] and is currently active. She has a maximum benefit amount.
[CUSTOMER][NEUTRAL] OK, can I.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Of $500 per calendar year with a $50 deductible that does not apply to us preventative services and this is not a guaranteed benefits just a disclaimer or the policy's coverage.
[CUSTOMER][NEUTRAL] OK, and then I'd like to check eligibility for 3 codes.
[AGENT][NEUTRAL] What is your first procedure code?
[CUSTOMER][NEUTRAL] 0120.
[CUSTOMER][NEUTRAL] And you
[AGENT][NEUTRAL] D 0120.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] They falls on the preventative at 100%. The limitations are as follows, limited to two or evaluation procedures and any combination of D0120,0140, B0150 and D0160 per 12 month period.
[CUSTOMER][NEUTRAL] OK, are they still eligible for one more?
[AGENT][NEUTRAL] So you want to check the history?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] You have on file is D0150D0210 D1110 [PII].
[CUSTOMER][POSITIVE] That's fine, thank you very much and um can we do fluoride on them?
[AGENT][NEUTRAL] Her fluoride is
[AGENT][NEUTRAL] Um, CG.
[AGENT][NEUTRAL] Maximum of 1 procedure for 12 months, limited to dependent children aged [PII].
[CUSTOMER][NEUTRAL] OK, thank you very much. Can I please have the spelling of your name and the reference number?
[AGENT][NEUTRAL] [PII] yellow, L as in Lima, A as in Alpha, and unfortunately we don't provide reference numbers [PII], so you can use my name in today's date as a reference.
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] You're welcome thanks for calling ATL and have a great day.
[CUSTOMER][NEUTRAL] Bye.