AccountId: 011433970860
ContactId: b0356ce0-717b-41fa-85a1-42527a54b7c0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 372160 ms
Total Talk Time (AGENT): 137879 ms
Total Talk Time (CUSTOMER): 125510 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/b0356ce0-717b-41fa-85a1-42527a54b7c0_20250304T18:45_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. This is [PII] calling from dental office checking for claim status.
[AGENT][NEUTRAL] Yes, I'm sorry, I didn't catch your name.
[CUSTOMER][NEUTRAL] Can this
[AGENT][NEUTRAL] [PII], OK, yes, I can certainly help with a claim status. [PII]. What is that policy number, please?
[CUSTOMER][NEUTRAL] I have 025647774.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] First name will be [PII] [PII].
[AGENT][NEUTRAL] Thank you. And is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] OK, sure. I have [PII].
[AGENT][NEUTRAL] Thank you. OK. And what date of service are we looking for for [PII]?
[CUSTOMER][NEUTRAL] I have general 8225 amount of $1,671.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Welcome.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Now, is this for um
[AGENT][NEUTRAL] Periodontal scaling.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Uh, it's for 1206.
[AGENT][NEUTRAL] OK, I see.
[AGENT][NEUTRAL] OK, so the claim number is 355.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] 1605.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And uh,
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] It looks like we received your claim.
[AGENT][NEUTRAL] On the [PII], we processed it on the [PII].
[AGENT][NEGATIVE] It, [PII], it doesn't look like any of these procedures are covered. The, the policy is very, very limited. Um, it, it just covers basic, basic restorative and preventative services only. Um, Perial maintenance is not covered at all.
[CUSTOMER][NEUTRAL] You know
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so the claim was denied because of that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, uh, what about for 1206?
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, that was also, that also is not covered.
[CUSTOMER][NEUTRAL] OK. It was uh not covered to the age limit or just for the procedure cost.
[AGENT][NEUTRAL] It's just because of the policy. The policy doesn't cover it.
[CUSTOMER][POSITIVE] OK, I got it. Thank you so much for the same. I'm doing this question before I can just provide my call reference number.
[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 our reference. Is there anything else I can help with?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] Yes, I have another one patient. Can you please help me with that one?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, and what is that policy number, please?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I have 02564. I'm so 02565683.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] something
[AGENT][NEUTRAL] And I'm sorry, do you mind repeating that again? I didn't catch it the first time. You said 02.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 565683.
[AGENT][NEUTRAL] OK, thank you. And the insured's name and date of birth, please?
[CUSTOMER][NEUTRAL] By [PII] [PII].
[AGENT][POSITIVE] Thank you. And the date of service for Margo?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII], with the amount of $2,394.
[AGENT][NEUTRAL] OK. Let's check.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] OK, your claim number on this is 3549634.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Checking. It looks like nothing that was
[AGENT][NEUTRAL] It doesn't look like any of the services are covered. I'm just checking again.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] B.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the, um, no the, the, uh,
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] 0173.
[AGENT][NEUTRAL] Services are covered.
[CUSTOMER][NEUTRAL] 499
[AGENT][NEUTRAL] Um, nothing for dental or, or, um, or vision, uh, is covered even if it's an accident. So, this isn't covered on this policy.
[CUSTOMER][NEUTRAL] Oh, you mean there is no dental coverage for this patient, right? I mean for these claims.
[AGENT][POSITIVE] That's correct. That's right.
[CUSTOMER][NEUTRAL] OK, and when was the glo was on?
[AGENT][NEUTRAL] Uh, looks like, uh, let's see here. Let's check.
[AGENT][NEUTRAL] It looks like that claim was um we received the claim.
[AGENT][NEGATIVE] On the [PII] and it was denied on the [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, what will be the termination date for this one?
[AGENT][NEUTRAL] It's uh my name which is [PII] in today's date.
[CUSTOMER][POSITIVE] OK, got it. Thank you so much for it, [PII]. That's all I want to confirm.
[AGENT][POSITIVE] OK, well, thank you for contacting AT. Have a good day.