AccountId: 011433970860
ContactId: b1fa6207-fb0c-46ef-bf7d-98a7941afda0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 382230 ms
Total Talk Time (AGENT): 158481 ms
Total Talk Time (CUSTOMER): 102086 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/b1fa6207-fb0c-46ef-bf7d-98a7941afda0_20250311T16:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, sorry, this is [PII], dental benefit for the patient. Could you please help me with that?
[AGENT][NEUTRAL] Uh, yes, I can help you with benefits for a patient, [PII]. Can I please get your callback number, sir, and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Sure. Callback number [PII].
[CUSTOMER][NEUTRAL] Her name is [PII] Dentistry.
[AGENT][NEUTRAL] OK, thank you and what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Policy number 2441177.
[CUSTOMER][NEUTRAL] Name [PII], [PII].
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[AGENT][NEUTRAL] OK, I do show that guy does have an active policy and the effective date of the policy is [PII] and if you give me your fax number, I will send you a fax back with the benefit breakdown and fee schedule.
[CUSTOMER][NEUTRAL] I have the breakdown, just send a few information.
[AGENT][NEUTRAL] OK, yes sir.
[CUSTOMER][NEUTRAL] OK. OK. Just to make sure, group number is 17626.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK. And out of maximum deductible, any used amount like out of 1500?
[AGENT][NEUTRAL] Let me look real quick for you, sir.
[AGENT][NEUTRAL] And this will be just to verify benefits it's not a guarantee of payment.
[AGENT][NEUTRAL] Let me see what he has.
[AGENT][NEUTRAL] He still has his deductible left to pay and he still has his calendar year benefit mount.
[AGENT][NEUTRAL] Full amount left.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And there is no ortho right for adult.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mm, there's a missing tooth cloth, right, with no waiting period?
[AGENT][NEUTRAL] I'm sorry, what did you, can you repeat that question?
[CUSTOMER][NEUTRAL] There is a missing tooth cloth, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And just make sure waiting period already satisfied, right?
[AGENT][NEUTRAL] What has been satisfied, sir?
[CUSTOMER][NEUTRAL] Waiting period?
[AGENT][NEUTRAL] I'm sorry, can you repeat that first part?
[CUSTOMER][NEUTRAL] Waiting period?
[AGENT][NEUTRAL] Can you spell that for me, sir?
[CUSTOMER][NEUTRAL] Uh waiting period like W A I T I N G.
[AGENT][NEUTRAL] Whitening
[CUSTOMER][NEUTRAL] Uh, waiting, wait, wait.
[AGENT][NEUTRAL] Oh, the bite wing, bit wing.
[CUSTOMER][NEUTRAL] No, no. No, the wait, wait, waiting period.
[AGENT][POSITIVE] Oh, waiting period. I'm so sorry. I've got you. I got you now. I'm sorry.
[CUSTOMER][NEUTRAL] Like this patient have to wait.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, let me look real quick.
[AGENT][NEUTRAL] I'm pulling up the facts back real quick just check that for you, sir.
[AGENT][NEUTRAL] The waiting period is only for major expenses, endodontic, periodontic, prosthodontic, and oral surgery, and that is a twelve-month waiting period. Cleanings.
[AGENT][NEUTRAL] Is once every 6 months?
[AGENT][NEUTRAL] Exams, he gets 2 every 12 month period.
[AGENT][NEUTRAL] Bite wings he gets once every 12 months.
[AGENT][NEUTRAL] And full mouth X-rays are once every 5 years and crowns and bridges are once every 7 years per tooth, and partials and dentures are once every 5 years. This is the only waiting periods that he has.
[CUSTOMER][NEUTRAL] So effective is [PII], right? So no longer apply, right, waiting period.
[CUSTOMER][NEUTRAL] 12 month pass, right?
[AGENT][POSITIVE] Correct. Yes. He's past that. Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And no downgrade right for composite and ground.
[AGENT][NEUTRAL] For composite and crown, there's no, can you repeat the question again?
[CUSTOMER][NEUTRAL] No downgrade, right? Like alternate benefit or no?
[AGENT][NEUTRAL] No, no downgrade.
[CUSTOMER][NEUTRAL] OK. And it's 18,040 plan?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And lastly, any history which can affect frequency?
[AGENT][NEUTRAL] Any frequency for.
[CUSTOMER][NEUTRAL] I know history.
[AGENT][NEUTRAL] History? Let me look real quick.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No history. This insured has never filed a claim.
[CUSTOMER][NEUTRAL] No history at all, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK and last the group name, is it Universal Ting Stevens Transport?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] And COP standard, right, with calendar plan?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, well, OK, that's all the information needed. Thank you.
[AGENT][POSITIVE] You're very welcome. [PII], is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] That's all.
[AGENT][POSITIVE] Alright, well you have a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] Good day.
[CUSTOMER][POSITIVE] Thank you. Bye.
[AGENT][NEUTRAL] Bye-bye.