AccountId: 011433970860
ContactId: cb68dcd0-5b32-494b-bb00-5bcaa5c27853
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288410 ms
Total Talk Time (AGENT): 151160 ms
Total Talk Time (CUSTOMER): 47837 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/cb68dcd0-5b32-494b-bb00-5bcaa5c27853_20250603T14:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII]. I'm with Doctor [PII] office. I have called twice trying to get a, um, facts of benefits on a patient, and it may at this point just be easier to get them verbally.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, alright, I'm sorry you haven't received your fax, Ms. [PII], can um I get your call back number and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] It is [PII] and it's gonna be Doctor [PII].
[AGENT][NEUTRAL] OK, and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] It is [PII]. Date of birth is [PII]. Policy number is 02613959.
[AGENT][NEUTRAL] OK, let me pull up his policy.
[AGENT][NEUTRAL] Alright, and I do show that his policy is active, um, now if you wanted me to try to send the um fee schedule a benefit breakdown for you again I'll pay attention to it and if it.
[AGENT][NEUTRAL] Abandons or anything happens along the way, I'll make sure I resend it until it's there.
[CUSTOMER][NEUTRAL] OK, um, I mean it may, it may just be easier to do it verbally.
[AGENT][NEUTRAL] Or
[AGENT][NEUTRAL] OK, that's fine, we can do that.
[AGENT][POSITIVE] Let me get his um benefits pulled up real quick, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If I didn't have patience in the office, it wouldn't be so bad, but
[AGENT][NEUTRAL] Right, I understand. Yes, ma'am.
[AGENT][NEUTRAL] OK, let me get his sheet pulled up so that I can read off of it for you.
[AGENT][NEUTRAL] OK, I have his benefits pulled up now so we can look at it together. Um, I can tell you that he has a calendar year maximum of $750 with a $50 deductible that's still left to pay, and he has not used any of his benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is just to verify his benefits, it's not a guarantee of payment. If you um.
[AGENT][NEUTRAL] I can uh give you his um waiting period. There's no waiting period for preventative radiographs, basic or basic restorative.
[AGENT][NEUTRAL] His preventative expenses are paid at 100% of allowable and the deductible does not apply to preventative.
[AGENT][NEUTRAL] His um radiograph FMX expenses, basic and restorative are 80% of allowable, and we pay off of the UCR fee schedule.
[AGENT][NEUTRAL] Um, his frequencies, he has cleanings once every 6 months.
[AGENT][NEUTRAL] An oral evaluation 2 per 12 month period.
[AGENT][NEUTRAL] Bite wings are once every 12 months.
[AGENT][NEUTRAL] And full mouth X-ray panoramics are once every 5 years.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] The policy does have a missing tooth clause.
[AGENT][NEUTRAL] And then if you need me to look up procedure codes I can do that also if you wanna give them to me.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] What is his major coverage?
[AGENT][NEGATIVE] He has no major coverage.
[CUSTOMER][NEUTRAL] 9 OK.
[CUSTOMER][POSITIVE] All right, I think that was all that I needed.
[AGENT][POSITIVE] So good.
[AGENT][POSITIVE] Well that was easy.
[AGENT][POSITIVE] And quick
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] OK. Well, I appreciate you calling, Ms. [PII]. I hope you have a wonderful rest of your day and thank you for calling APL.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Alright you take care bye bye ma'am.
[CUSTOMER][NEUTRAL] You too bye bye.