AccountId: 011433970860
ContactId: 0dc2f704-b4a5-4905-86f5-fdf685e50f10
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188529 ms
Total Talk Time (AGENT): 60105 ms
Total Talk Time (CUSTOMER): 111783 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/0dc2f704-b4a5-4905-86f5-fdf685e50f10_20250326T14:42_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling up from a dental office. One of our patients, um, has your insurance for dental. We're looking to see what fee schedule we go by, um.
[CUSTOMER][NEUTRAL] For charging
[CUSTOMER][NEUTRAL] We don't have a fee schedule on file. Is there, is it possible because we called someone called before to try to get a fee schedule and, and all they got was just the benefits fax back. So we, we actually need like codes and what your pricing is, or do we go by another fee schedule?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'll be checked, uh, I'll be happy to check the status of that. May I have that policy number please?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] 774982.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. Please be advised the verification of coverage is not a guarantee of payment. Now I'm showing with this policy you would go by UCR.
[AGENT][NEUTRAL] So the fax back just shows you the codes that are covered and then you would go by UCR.
[CUSTOMER][NEUTRAL] Yeah oh
[CUSTOMER][MIXED] Covered OK, so codes covered so.
[CUSTOMER][NEUTRAL] You would cover the percentage that's on the fax back and then the remaining is.
[CUSTOMER][NEUTRAL] Is our fee
[CUSTOMER][NEUTRAL] Is that is that what you mean because you see our means it's, it's our office's fee because it looked like she had OK so how do we I'm, I'm just confused how that gets figured out.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] In regards to billing because if we go by with the half remaining that you paid, oh I guess because there's no adjusting, we would just go by what's left over.
[CUSTOMER][NEUTRAL] Is is that how I'm to understand it?
[AGENT][NEUTRAL] I just know we go by if you charge 50 and it's a basic then we're gonna pay the 80% of 50 after she's met her deductible.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, so I got it. Alright, alright, so that's all we need to know then. So just whatever your percentage covered is what you pay and then whatever's left over, there's no adjusting we just pay we just bill the patient.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, alright, so and there's no, there's no actual like codes with fees on them from you guys.
[CUSTOMER][NEUTRAL] We don't need to go by another like no denimax or anything.
[AGENT][NEUTRAL] No, not this policy. We have policies that have actual.
[AGENT][NEUTRAL] We have policies that.
[CUSTOMER][NEUTRAL] Do you know what I mean like there's
[CUSTOMER][POSITIVE] Good, I'm sorry, I don't mean to interrupt you.
[AGENT][NEUTRAL] Oh, that's fine. We have policies that have actual, we list the code and we then we'll say we'll pay $76 for this code, but this policy she has, we don't do that we go by UCR for this policy that she has.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][POSITIVE] I see OK all right I get it now right, so then that's all I need to know. I will let the other girl know how we we handle that then thank you so much for your help. I appreciate it.
[AGENT][POSITIVE] OK, well thank you for calling APL you have a good day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][NEUTRAL] Mm. Bye-bye.