AccountId: 011433970860
ContactId: 03bb1aa4-c978-41f6-a819-8349490a7f55
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201149 ms
Total Talk Time (AGENT): 93199 ms
Total Talk Time (CUSTOMER): 80021 ms
Interruptions: 0
Overall Sentiment: AGENT=2.2, CUSTOMER=2.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/03bb1aa4-c978-41f6-a819-8349490a7f55_20250129T20:04_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] So but.
[CUSTOMER][NEUTRAL] a call for.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, sorry, this is [PII]. Can I help you?
[CUSTOMER][NEUTRAL] Hi, hi, yes, I was calling to confirm coverage for one of our patients, um, and just also see if we're considered in network with this plan.
[AGENT][POSITIVE] OK, yeah, I'd love to help you with coverage details and that work today. Um, may I get your name please, and a good callback number?
[CUSTOMER][NEUTRAL] Of course my name is [PII] and best contact number is [PII].
[AGENT][POSITIVE] Wonderful, Ms. [PII], and
[AGENT][NEUTRAL] Do you mind if I snag that policy number for you today?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Do you mind if I snag that policy number?
[CUSTOMER][NEUTRAL] Of course, yes, uh, policy number is 02450576.
[AGENT][POSITIVE] Perfect. And give me just a couple moments to get that policy pulled up for you.
[CUSTOMER][POSITIVE] Awesome thank you.
[AGENT][POSITIVE] Oh, it's my pleasure.
[AGENT][NEUTRAL] And what is the name of the member we want to look at today?
[CUSTOMER][NEUTRAL] Uh patient's gonna be [PII]. Last name is [PII]
[AGENT][NEUTRAL] Thank you, and his date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. I do see [PII] here. He's current and active with us. Um, as far as this policy goes, um,
[AGENT][NEUTRAL] We, this policy is based off of the Carrington PPO fee schedule. However, you don't have to be a Carrington PPO provider. Um, we honor benefits with any dental group, so there's no genuine network for this plan.
[CUSTOMER][NEUTRAL] OK, there's no network. OK, um, can you, are you able to give me like um a fee schedule for this plan?
[AGENT][NEUTRAL] Yeah, I do have a fax back available that I could send out to you if you would like and that would have the full breakdown for you.
[CUSTOMER][POSITIVE] Yeah, that would be great.
[CUSTOMER][NEUTRAL] OK, because I did get a breakdown faxed over, but it doesn't state like.
[CUSTOMER][NEUTRAL] Does this go like off UCR fees then if we're not in network with Carrington?
[AGENT][NEUTRAL] Oh, it, it follows the Carrington Network fee schedule, um, completely all the way through, but you don't have to be a Carrington PPO provider to be eligible for, um,
[AGENT][NEUTRAL] For benefits.
[CUSTOMER][NEUTRAL] OK, and now the benefits would go to the provider or does these benefits go to the patient?
[AGENT][NEUTRAL] Oh, they go to the provider.
[CUSTOMER][NEUTRAL] They would OK awesome and what is a payer ID for this plan just because I'm not familiar with this plan.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No worries, that electronic payer ID is 60801.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][POSITIVE] OK awesome and thank you so much for your help I appreciate it.
[AGENT][POSITIVE] Oh, it's my pleasure if you need anything else along the way, just give us a call back we'll be so happy to take care of you.
[CUSTOMER][POSITIVE] Awesome, thank you so much. You have a good day.
[AGENT][POSITIVE] My pleasure. You too. Bye bye.
[CUSTOMER][POSITIVE] Thanks bye bye.