AccountId: 011433970860
ContactId: bca96043-927b-482a-960c-77921d48b6cb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 622760 ms
Total Talk Time (AGENT): 168495 ms
Total Talk Time (CUSTOMER): 111320 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/bca96043-927b-482a-960c-77921d48b6cb_20250403T20:00_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Jefferson Dental. How are you doing today?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][POSITIVE] Yeah, I'm also good. I need eligibility and benefits of this patient. Could you help me for that?
[AGENT][NEUTRAL] Yes, ma'am. First, could I get your name again and a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your name, please?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, thank you, and now I need the policy number, please.
[CUSTOMER][NEUTRAL] 00914813
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK. Thank you. And do you need to verify benefits or do you need to um
[AGENT][NEUTRAL] Check on the status of a claim.
[CUSTOMER][NEUTRAL] Specific questions.
[CUSTOMER][NEUTRAL] Benefits.
[AGENT][NEUTRAL] Just let me advise you that verification of coverage does not guarantee payment of claims. The effective date on this policy was [PII].
[AGENT][NEUTRAL] Of [PII], the policy is still active. And yes, ma'am, what's your question?
[CUSTOMER][NEUTRAL] Just a second, ma'am.
[CUSTOMER][NEUTRAL] Please repeat it again the effective date of this patient.
[AGENT][NEUTRAL] The effective date is [PII].
[CUSTOMER][NEUTRAL] Patient is the policyholder of this plan.
[AGENT][NEUTRAL] Yes, ma'am. Yes.
[CUSTOMER][NEUTRAL] Deductibles and early max, please.
[AGENT][NEUTRAL] Annual maximum is $1500 per calendar year, and then there's a $50 deductible.
[CUSTOMER][NEUTRAL] Family is 150.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] May I know the family deductible?
[AGENT][NEUTRAL] Yes, it's 150 for the entire family, but he's the only one on the policy.
[CUSTOMER][NEUTRAL] Deductible sorry, may I know the coin that this is a preventive basic major?
[AGENT][NEUTRAL] OK, let's see. It's 80% for major, well, it's 40% for major.
[AGENT][NEUTRAL] And what was the other question?
[CUSTOMER][NEUTRAL] Preventive basic?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 70 basic percentage, ma'am.
[AGENT][NEUTRAL] The basic is 80%.
[CUSTOMER][NEUTRAL] Preventive
[AGENT][NEUTRAL] Preventative is 100%.
[CUSTOMER][NEUTRAL] Group name and group number?
[AGENT][NEUTRAL] Please repeat the question.
[CUSTOMER][NEUTRAL] May I know the group name and group number?
[AGENT][NEUTRAL] Yes, ma'am, the group.
[AGENT][NEUTRAL] The group number is 14564.
[AGENT][NEUTRAL] And the group Universal Trucking.
[CUSTOMER][POSITIVE] Good name.
[CUSTOMER][NEUTRAL] Group name, ma'am.
[AGENT][NEUTRAL] The group name is Universal Trucking.
[AGENT][NEUTRAL] Anderson Flatbed.
[CUSTOMER][NEUTRAL] Is there any huge amount from deductibles and nearly max?
[AGENT][NEUTRAL] One moment, let me check. One moment.
[AGENT][NEGATIVE] No, nothing has been used so far.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes, ma'am. Um,
[CUSTOMER][NEUTRAL] There is no used amounts from deductibles and yearly max, right?
[AGENT][NEUTRAL] Right, there's no charges towards that.
[CUSTOMER][NEUTRAL] Man
[CUSTOMER][NEUTRAL] Orthodontic full breakdown, please.
[AGENT][NEUTRAL] Orthodontic treatments are not covered under the policy.
[CUSTOMER][NEUTRAL] May I know the history which might affect the frequency?
[AGENT][NEUTRAL] What type of frequency?
[CUSTOMER][NEUTRAL] May I know the history of this patient, which might affect the frequency?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK. Limited to 1 X-ray every 5 years?
[AGENT][NEUTRAL] That affects the frequency?
[AGENT][NEUTRAL] And also,
[CUSTOMER][NEUTRAL] And date of service?
[AGENT][NEUTRAL] Date of service was [PII].
[CUSTOMER][NEUTRAL] FMX and pano, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Next history.
[AGENT][NEUTRAL] There's one more. Let's see.
[AGENT][NEUTRAL] Oh, no, that's the only one.
[CUSTOMER][NEUTRAL] It is only the history which might affect the frequency?
[AGENT][NEUTRAL] Please repeat the question.
[CUSTOMER][NEUTRAL] And it's
[CUSTOMER][NEUTRAL] Is this is only the history which might affect the frequency, ma'am?
[AGENT][NEUTRAL] No, I'm not showing any.
[CUSTOMER][NEUTRAL] OK. Uh, may I know the 6104 and 7953 frequency and percentage, please?
[AGENT][NEUTRAL] What's the code?
[CUSTOMER][NEUTRAL] 6104 and 7953.
[AGENT][NEUTRAL] OK. I'm not showing a 6174 on the um
[CUSTOMER][NEUTRAL] 6104, ma'am.
[AGENT][NEUTRAL] On the
[AGENT][NEUTRAL] 6104. Yes, ma'am. I'm not showing that one. And what was the other code?
[CUSTOMER][NEUTRAL] 7953
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] I'm not showing a 7953. I show a 7960.
[CUSTOMER][NEUTRAL] 7953 is not showing.
[AGENT][NEUTRAL] Right, I'm not showing a 7953. The closest one to that I'm showing is a 7960, but the 7953 is not showing.
[CUSTOMER][NEUTRAL] OK. Bro graft is covered.
[AGENT][NEUTRAL] What's the code for that?
[CUSTOMER][NEUTRAL] Implants
[CUSTOMER][NEUTRAL] Implants
[AGENT][NEUTRAL] Oh, implant.
[CUSTOMER][NEUTRAL] OK, ma'am
[CUSTOMER][NEUTRAL] May I know the schedule of this policy?
[CUSTOMER][NEUTRAL] Reschedule, ma'am.
[AGENT][NEUTRAL] Usual and customary.
[AGENT][NEUTRAL] And we do work with Carrington Network, but it's not required.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the call reference number and your name, please?
[AGENT][NEUTRAL] The call reference number is my name and today's date. My name is [PII], um it's spelled [PII] Last initial is [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, ma'am. Thank you so much for your information. Have a great day. Bye bye.
[AGENT][NEUTRAL] You do the same. Thank you for calling ATL. Mm bye.