AccountId: 011433970860
ContactId: e0a3db4c-c66f-4e16-a2d3-c170c749c9e1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 321640 ms
Total Talk Time (AGENT): 133916 ms
Total Talk Time (CUSTOMER): 139859 ms
Interruptions: 4
Overall Sentiment: AGENT=1.1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/e0a3db4c-c66f-4e16-a2d3-c170c749c9e1_20250507T17:57_UTC.wav
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[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, um, I'm calling in regards of a mutual patient. Um, his name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] May I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] My name is [PII]. Our phone number is [PII].
[AGENT][NEUTRAL] And where are you calling from? What what's the name of the facility, Ms. [PII]?
[CUSTOMER][NEUTRAL] Mile Square Park Family Dental in [PII].
[AGENT][NEUTRAL] OK, and do you have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Um, it should be.
[CUSTOMER][NEUTRAL] OK, it should be 0214.
[CUSTOMER][NEUTRAL] 7862.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] And again, may I have the name and date of birth of the patient for verification?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you. And you're calling today to get eligibility benefits or what information are you needing for that?
[CUSTOMER][NEUTRAL] Um, I need a benefit information starting with the, um, deductible.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And yearly maximum?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You need this information given to you verbally or faxed over to you?
[CUSTOMER][NEUTRAL] Verbally please.
[AGENT][NEUTRAL] OK, bear with me, let me pull up this information.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] You know.
[CUSTOMER][POSITIVE] Yes, hi, how can I help you?
[CUSTOMER][NEUTRAL] OK, I just want to let her know that I can then go in works this way.
[AGENT][NEUTRAL] OK, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[AGENT][NEUTRAL] And this policy has a calendar year deductible of $50.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] And the maximum benefit of 500. This is one of our basic dental policies.
[CUSTOMER][NEUTRAL] The price of this.
[CUSTOMER][NEUTRAL] OK, and then, um, this is, does this apply to preventative, basic, and major? All three? No major?
[AGENT][NEUTRAL] There's no major services. There's no major services on this policy, no. This is only for preventative radiograph FMX basic and basic restorative only. Um, the deductible does not apply towards the preventative, but the maximum supplies to everything.
[CUSTOMER][NEUTRAL] I will.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So deductible is only for basic.
[AGENT][NEUTRAL] Basic and radiograph FMX.
[CUSTOMER][NEUTRAL] OK, and then has any of his um maximum been used in used sorry?
[AGENT][NEUTRAL] Yes. Um, yes, he has used $68. He has the remaining $432 and he has not met his deductible.
[CUSTOMER][NEUTRAL] OK, um, and then how much is what percent is the preventative at?
[AGENT][NEUTRAL] Preventative is covered 100%. Radiograph FMX is cover 80. Basic expense and basic restorative is 80.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] worth of.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Basic is 80 you said right?
[AGENT][NEUTRAL] Correct, yes. Now, under the major, um, it's included um the endozonics, periodontics, prosthodontic repair and neurosurgeries, so all those are not covered.
[CUSTOMER][NEUTRAL] No major.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Periodontal coverage.
[AGENT][NEGATIVE] No, there's no coverage for that.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No implant coverage, nothing like that, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No oral implants, right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Working on
[CUSTOMER][NEUTRAL] Insurance me or who?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK sounds good. I think that's all I need for now.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK. Is there anything else for me?
[CUSTOMER][NEUTRAL] And then you said FMX 80, right?
[AGENT][NEUTRAL] Yes, FMX um radiograph FMX is 80.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][POSITIVE] You need any second. You're welcome. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] Alrighty thank you so much.
[CUSTOMER][POSITIVE] That'll be all thank you.
[AGENT][POSITIVE] OK, you're welcome and thank you for calling ATO. Have a good day, Ms. [PII].
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you.