AccountId: 011433970860
ContactId: eb364634-5a34-4265-8153-45bfefc57206
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 410010 ms
Total Talk Time (AGENT): 162206 ms
Total Talk Time (CUSTOMER): 130153 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/eb364634-5a34-4265-8153-45bfefc57206_20250522T20:00_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]. That's [PII]. I'm trying to get dental benefits for two patients.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with benefits. Um, may I please get your callback number just in case the call's dropped and also the facility that you're from?
[CUSTOMER][NEUTRAL] Yes, yes, ma'am. It's Southeastern Oral Surgery and Dental implant.
[CUSTOMER][NEUTRAL] And the callback number is [PII].
[AGENT][NEUTRAL] OK. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] The first one, I, I think they're brother and sister, um, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, the contract number says 02504688.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK. I've got [PII] and then um you, you said that maybe a sister is on the policy also. Can you give me sister's information?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Delay or something.
[CUSTOMER][NEUTRAL] Yeah, it looks like [PII] or something. Her birthday is um.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right, let me get over here and I'll give you the effective date.
[AGENT][NEUTRAL] Uh, [PII]'s effective date is [PII] and the policy is active.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And if you want to give me your fax number I can send you a fax back with their benefit breakdown and fee schedule.
[CUSTOMER][NEUTRAL] Um, can I just ask you the questions that I need? I would, I don't even need the print out.
[AGENT][POSITIVE] Oh, OK, yes, ma'am. You can do that.
[CUSTOMER][NEUTRAL] Uh huh. First I need to make sure that we're in network.
[AGENT][NEUTRAL] OK, so with this policy, they can go to anybody that they want to use.
[CUSTOMER][NEUTRAL] OK, so there's no network?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And they're using two different doctors here, um, on [PII], what, what the schedule will we use? Will we just use UCR or?
[AGENT][NEUTRAL] Yes ma'am, UCR.
[CUSTOMER][NEUTRAL] UCR OK, did they don't have a waiting period, either one of them?
[AGENT][NEUTRAL] Let me look at the facts back real quick, pull up their benefits so I can let you know that.
[AGENT][NEUTRAL] That's gonna be just a moment while I pull up their benefits.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] They do not have um and this is just to verify their benefits, it's not a guarantee of payment. They do not have uh.
[AGENT][NEUTRAL] Waiting period for preventative or basic or radiographs at all.
[CUSTOMER][NEUTRAL] OK, do they have, um, a missing tooth cloth?
[AGENT][NEUTRAL] Yes, it does have a missing tooth clause.
[CUSTOMER][NEUTRAL] OK, they're just having wisdom teeth pulled, so that's not gonna matter.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] How about a deductible?
[AGENT][NEUTRAL] Yes, ma'am, a $50 deductible per covered insured.
[AGENT][NEUTRAL] Up to 150 for the family.
[CUSTOMER][NEUTRAL] Have
[CUSTOMER][NEUTRAL] Have they met it at all, any of it?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] [PII] has, but uh [PII], [PII] or [PII], she has not.
[CUSTOMER][NEUTRAL] I guess [PII]. OK. And what about [PII]'s maximum?
[AGENT][NEUTRAL] OK, so they each have a $500 maximum per calendar year, and [PII] has $328 left and [PII] has $300 left.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] I have 4 codes for [PII] to check and I have 3 for her and hers are the same as his. He's just got an extra one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] All right, what's the first code?
[CUSTOMER][NEUTRAL] D 9222.
[AGENT][NEUTRAL] OK, that code is not showing up on the fax back, so it's not a covered service.
[CUSTOMER][NEUTRAL] OK, uh, 9223, it probably isn't either.
[AGENT][NEUTRAL] If they don't have any major, it's just basic and um preventative. Yes, uh 9223.
[CUSTOMER][NEGATIVE] OK, so this may not even be covered.
[AGENT][NEGATIVE] And that's not showing up either so it's not covered.
[CUSTOMER][NEUTRAL] And um 7230.
[CUSTOMER][NEGATIVE] None of these probably are gonna be.
[AGENT][NEGATIVE] And that's yeah that's not showing up either.
[CUSTOMER][NEUTRAL] And 7240.
[AGENT][NEGATIVE] And that one is not showing up either.
[CUSTOMER][NEUTRAL] OK and um.
[CUSTOMER][NEUTRAL] A reference number for the call Miss [PII]?
[AGENT][NEUTRAL] Yes, you can use my name and today's date.
[CUSTOMER][POSITIVE] All right. Thank you so much.
[AGENT][POSITIVE] Well, you're so welcome, Miss [PII]. I, is that everything I can help you with before we go?
[CUSTOMER][NEUTRAL] That is it.
[AGENT][POSITIVE] OK, well, I hope you have a good Memorial Day weekend and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you, you too.
[AGENT][POSITIVE] You're welcome. Bye-bye, Ms [PII].
[CUSTOMER][NEUTRAL] Bye bye.