AccountId: 011433970860
ContactId: e7f3931c-a248-4409-ac7b-06cdbfbe4b5d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 158740 ms
Total Talk Time (AGENT): 86358 ms
Total Talk Time (CUSTOMER): 55850 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/e7f3931c-a248-4409-ac7b-06cdbfbe4b5d_20250213T15:35_UTC.wav
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[AGENT][NEUTRAL] For contacting ATO, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] with Anderson and Floyd Dentistry. I'm trying to find benefits and eligibility for one of our patients.
[AGENT][NEUTRAL] OK, [PII], I can certainly help with benefits and eligibility. What is that policy number, please?
[CUSTOMER][NEUTRAL] Um, it is 02589583.
[AGENT][NEUTRAL] Thank you, and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Um, [PII] date of birth is [PII].
[AGENT][NEUTRAL] Thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The policy went into effect on [PII] or will go into effect on [PII]. Um, it, uh, will be active as of that date. Let me just check here and see if he has previous coverage.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] No, it looks like everything begins on [PII]. Now, at that time, um, what he will have is $1500 for calendar year for basic, basic restorative and preventative services.
[AGENT][NEUTRAL] Um, the major coverage does have a 12 month waiting period.
[CUSTOMER][NEUTRAL] Major coverage does?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 12 months and that would include root canals, crowns.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, um, what is he covered for restorative for res um.
[CUSTOMER][NEUTRAL] Fillings
[AGENT][NEUTRAL] That would be up to 80% of UCR.
[CUSTOMER][NEUTRAL] OK, and then Endo, what is he covered for Endo when after the 12 months?
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] After the 12 months that would be at 40%. Now I, I do have a uh fact fact that shows all the benefits as well as where to send your claim, and we do pay a percentage of the UCR and it, it lets you know what we pay and and where to send your claim.
[AGENT][NEUTRAL] If you would like that.
[CUSTOMER][NEUTRAL] OK, would you be able to fax that? Yes.
[AGENT][NEUTRAL] Sure. What's your fax number?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And uh I, I will just reiterate that uh his policy doesn't start until March. But once it does, uh, yeah, all these benefits will be available except for the major coverage.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else at all that I can help with before I send off this fax?
[CUSTOMER][NEUTRAL] Nope, that is all.
[AGENT][POSITIVE] OK, well, thank you for contacting ATL mostly you have a very good day. You should be getting this just any time.