AccountId: 011433970860
ContactId: c7abe04b-c4dd-4624-9b83-2f73758c45e0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 253279 ms
Total Talk Time (AGENT): 127206 ms
Total Talk Time (CUSTOMER): 66886 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/c7abe04b-c4dd-4624-9b83-2f73758c45e0_20250501T18:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm with American Family Dentistry, and I need to see if we are in network with one of our new patients dental plans.
[AGENT][POSITIVE] All right, [PII]. I'm happy to check on a patient. What's their policy number?
[CUSTOMER][NEUTRAL] It is 02365849.
[AGENT][NEUTRAL] OK, let me pull that up.
[AGENT][NEUTRAL] And then if I could get the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It is [PII] [PII].
[AGENT][POSITIVE] Perfect. All right. So, patient is active. Uh, looks like the effective date on here is going to be [PII].
[AGENT][NEUTRAL] Uh looks like the member's plan does not require network for usage. It pays by UCR.
[AGENT][NEUTRAL] And then if you guys need we can also send a fax back for a breakdown.
[CUSTOMER][POSITIVE] Um, yes, if you could send the fax back, that would be great.
[AGENT][POSITIVE] Yeah, absolutely. um, what is a good fax number?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, and then should we mark that attention to you?
[CUSTOMER][NEUTRAL] Uh, yes, that'll be fine.
[AGENT][NEUTRAL] All right, is there anything else I can check on for you?
[CUSTOMER][NEUTRAL] Um, well, he, I'm trying to get him back right now. Um, what is his maximum deductible?
[AGENT][NEUTRAL] Uh, so it looks like the calendar year max on this is going to be $1500 and then the calendar year deductible is $50. Let me see what they've used.
[AGENT][NEUTRAL] So it looks like [PII] has a full $1500 remaining and the $50 deductible still.
[CUSTOMER][NEUTRAL] OK, could you give me a quick rundown of like his preventative basic and major percentages?
[AGENT][NEUTRAL] Absolutely preventative is covered at 100% of UCR radiographs, which is FMX basic expenses are covered at 80.
[AGENT][NEUTRAL] And then major expenses, this is gonna be endo perio oral surgery and that's all at 40%.
[CUSTOMER][NEUTRAL] 40
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and does he have any missing tooth claws or waiting period?
[AGENT][NEUTRAL] Uh, looks like there is a waiting period on major which is 12 months.
[AGENT][NEUTRAL] And policy does have a missing tooth clause.
[AGENT][NEUTRAL] They don't show any history on file so there shouldn't be anything that messes with frequencies.
[CUSTOMER][POSITIVE] OK perfect and then um.
[CUSTOMER][NEUTRAL] Do we just use the uh.
[CUSTOMER][NEUTRAL] Mailing address of [PII].
[AGENT][POSITIVE] Yes ma'am and then we have a payer ID and fax. It'll be on the fax back also, but if you'd like, I'm happy to provide that to you.
[CUSTOMER][POSITIVE] That would be wonderful.
[AGENT][NEUTRAL] Yeah, absolutely, so the payer ID is gonna be 60801.
[AGENT][NEUTRAL] And then the fax number?
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you said it's the UCR um is that the fee schedule?
[AGENT][POSITIVE] Uh-huh, correct, yes ma'am.
[CUSTOMER][POSITIVE] Awesome thank you so much sir I really appreciate it.
[AGENT][POSITIVE] Yeah, no worries, and that fax should be there in about 5 minutes, OK?
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.