AccountId: 011433970860
ContactId: ccbbdaf6-e4d8-4ef2-8a7d-6d26b1153908
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 540000 ms
Total Talk Time (AGENT): 175776 ms
Total Talk Time (CUSTOMER): 152795 ms
Interruptions: 5
Overall Sentiment: AGENT=1.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/ccbbdaf6-e4d8-4ef2-8a7d-6d26b1153908_20250310T20:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I need to get dental benefits for a patient please.
[AGENT][NEUTRAL] OK, I can help you with benefits. Can I please get your name, your number, and the facility you're calling from, please?
[CUSTOMER][NEUTRAL] Sure, my name is [PII].
[CUSTOMER][NEUTRAL] Telephone number [PII] and I'm calling from Doctor [PII], which is spelled like [PII]
[AGENT][POSITIVE] Thank you so much. I appreciate that. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Mhm sure.
[CUSTOMER][NEUTRAL] Uh patient named [PII]. Date of birth [PII].
[CUSTOMER][NEUTRAL] And I have a social.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Uh, no, no.
[CUSTOMER][NEUTRAL] No, I don't.
[CUSTOMER][NEUTRAL] Maybe this is I don't know um possibly the um member number is 613-760.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look that up real quick and see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, that is a good policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I do show that Mr. [PII] does have an active policy and his effective date is [PII].
[CUSTOMER][POSITIVE] Good deal.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if.
[CUSTOMER][NEUTRAL] And I am specifically looking for [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me get his benefits pulled up real quick.
[AGENT][NEUTRAL] OK, and this is just to verify his benefits. It's not a guarantee of payment.
[AGENT][NEUTRAL] And you said endo um is what you're looking for. What is that short for because I'm not real familiar with the.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And I'm sorry, ended root canal therapy endoonic therapy, mhm.
[AGENT][NEUTRAL] Root canal, OK. Endoonic, OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Do you have a um procedure number for that?
[CUSTOMER][NEUTRAL] A code I do. I sure do, um, in fact, there I have 22 different tes, so I'm looking at two different codes. The first one would be 3346.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me write that down. 3346.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see if that's on here.
[CUSTOMER][NEUTRAL] And then 334 7.
[AGENT][NEUTRAL] OK, I'm showing that we have codes for root canal.
[AGENT][NEUTRAL] Um, 3310.
[CUSTOMER][NEUTRAL] Mhm, this would be a.
[CUSTOMER][NEUTRAL] OK, these would both be retreat root canals.
[AGENT][NEUTRAL] Retreat. OK, let me see if I see anything that says retreat on this fax back real quick.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] I do not see retreat um 3346.
[AGENT][NEUTRAL] Still looking for the code on this.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Because if the code is not listed, then it's not covered. So let me look, keep looking.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][POSITIVE] I appreciate you
[AGENT][POSITIVE] Being patient with me.
[CUSTOMER][NEUTRAL] Oh sure.
[CUSTOMER][POSITIVE] Absolutely.
[AGENT][NEUTRAL] And is that considered um.
[AGENT][NEUTRAL] Major
[CUSTOMER][NEUTRAL] Um, on some policies, on some policies it's considered basic, um, it is on most policies it is considered major, but some policies it is basic.
[AGENT][NEUTRAL] OK, let me look under the basic also.
[AGENT][NEUTRAL] OK, I'm gonna look both.
[CUSTOMER][NEUTRAL] If um if the root canal like the 3310 or 3320 if those were under major this would definitely be major.
[AGENT][NEUTRAL] Yes, it's under root canals are under major and I'm not seeing.
[CUSTOMER][NEUTRAL] Yeah, I would
[AGENT][NEUTRAL] 334 6.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, most policies you get one per lifetime, you get one root canal and you get one retreat, so but.
[AGENT][NEUTRAL] 447.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, may not be that way with this policy.
[AGENT][NEUTRAL] Yeah, I'm not seeing either one of those but what I can do.
[AGENT][NEUTRAL] No, and I don't see them, so what I wanna do is I wanna be able to send you this uh fax back that has the complete benefit breakdown and the fee schedule so you can look at it too, but I'm not finding it, um, looking through.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] That'd be great.
[CUSTOMER][POSITIVE] That'd be great.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] At the same thing that you're gonna look at? I didn't see it. So if it's not on the fax back then it's not covered. So I wanted to make sure I looked real good. um, what is your fax number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, yeah, yeah.
[CUSTOMER][NEGATIVE] Not covered OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I'm gonna put you on a quick hold. I'm gonna get this fax ready for you and I'll be right back.
[CUSTOMER][NEUTRAL] Sure, OK.
[AGENT][POSITIVE] Thank you very much. I appreciate you being so understanding, Ms. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh thank you I appreciate you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, Miss [PII]. I've got that fax back on its way to you now.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Perfect thank you so much I appreciate your help today, [PII].
[AGENT][POSITIVE] You're very welcome. I hope you have a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.