AccountId: 011433970860
ContactId: 0edb2782-4060-4dd7-95d3-2197449a52cb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 402079 ms
Total Talk Time (AGENT): 121437 ms
Total Talk Time (CUSTOMER): 214255 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/0edb2782-4060-4dd7-95d3-2197449a52cb_20250129T19:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], is it with an H or no H?
[AGENT][NEUTRAL] I have an H at the end.
[CUSTOMER][NEUTRAL] Thank you. My name is [PII] calling from Greer Dental Studio. Can you help me with a patient, uh, that's had a change of insurance?
[AGENT][NEUTRAL] Yeah, well, let's take a look when, do you have a policy number?
[CUSTOMER][NEUTRAL] Uh, she's given me, um, and I think this is the one that is gonna be the correct 1, 02584729.
[AGENT][POSITIVE] OK, thanks.
[CUSTOMER][NEUTRAL] Under a [PII].
[AGENT][NEUTRAL] All right, take a look.
[AGENT][POSITIVE] Thank you. And then if I
[CUSTOMER][NEUTRAL] Yeah, the other one I think is probably your payer ID number.
[AGENT][NEUTRAL] Um, can I?
[CUSTOMER][NEUTRAL] Yeah, it's
[AGENT][NEUTRAL] Get [PII]'s date of birth.
[CUSTOMER][NEUTRAL] Yes, his date of birth is going to be [PII].
[CUSTOMER][NEGATIVE] I apologize, the phone is cutting in and out.
[AGENT][POSITIVE] Great, thank you so much.
[AGENT][NEUTRAL] Oh, I'm sorry. Um, so [PII]'s plan is active. The effective date on this is [PII].
[CUSTOMER][NEUTRAL] OK. Now, who's the
[AGENT][NEUTRAL] And then if you need us to, we can send a fax back to you.
[CUSTOMER][NEUTRAL] Carrier on this.
[AGENT][NEUTRAL] So, um, he is the subscriber, is that what you're asking?
[CUSTOMER][NEUTRAL] Well, uh, uh, like I said, the wife was sort of, uh, this is the 3rd different plan that she's given me, so, um, yeah, that's what I was trying to get a breakdown of his benefits. We need to see too if we're in network. Do you guys contract with Connection Dental?
[AGENT][NEUTRAL] So the policy does participate in the Carrington PPO network. however, it's not required for usage, and I can send you a fax back breakdown too.
[CUSTOMER][NEUTRAL] OK, alright, and what is the name of this? Is it Carrington APL?
[AGENT][NEUTRAL] APL is the name.
[CUSTOMER][NEUTRAL] OK, um, can you see if because I need to let them know if we are in or out of network, our tax ID is gonna be [PII].
[AGENT][NEUTRAL] I'm sorry, [PII], I wasn't quite go ahead.
[CUSTOMER][NEUTRAL] Because carrying
[CUSTOMER][POSITIVE] OK, no worries.
[CUSTOMER][NEUTRAL] Let me know when you're ready.
[AGENT][NEUTRAL] Um, go ahead, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Because there is a Carrington under the connection dental.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But it's not all the Carringtons that's what is sort of a little tricky with that when she was telling me Carrington.
[AGENT][NEGATIVE] I gotcha.
[AGENT][NEUTRAL] It's not pulling up so I'm not thinking that you guys are in network.
[CUSTOMER][NEUTRAL] You see, that's what I told her that I thought we would probably be out too, but like I said, there is one part under the connection dental that has a Carrington with it.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um, so are there benefits different in and out of network? I know they would be balance billed if we're out, so I wanna let them know that.
[AGENT][NEUTRAL] Believe it would be the same. The fee schedule on this is all by UCR it looks like.
[CUSTOMER][NEUTRAL] OK, so the percents would be like the same like 180, 50% if they go in or out of network but they just be balance billed.
[AGENT][NEUTRAL] Yeah, exactly. So yeah, and this plan is just preventative and basic, so it's just the 180 and 100.
[CUSTOMER][NEUTRAL] OK, so preventative basic only, right, no riders. OK, um, now are there, uh, are you putting the endo, um, perio oral surgery under basic or is that gonna fall under major?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] That falls under major.
[CUSTOMER][NEUTRAL] OK, so pretty much preventative restorative only is it individual or family? That's the other thing she couldn't tell me, so it's [PII] only.
[AGENT][NEUTRAL] Individual.
[AGENT][NEUTRAL] Individual, yeah.
[CUSTOMER][NEUTRAL] OK, so because that's what I asked her and you know, so, so [PII] only alright and let me give you our fax number how many pages?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] Uh, let's say 3 or 4, excuse me.
[CUSTOMER][NEUTRAL] And will it
[CUSTOMER][NEUTRAL] Perfect. Will it give me your um address? The payer is that the payer ID I think she gave me 60801.
[AGENT][POSITIVE] Yes ma'am, it is on there as well.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just so I have all the information in order to set the plan up, so is this through his employer or an individual policy?
[AGENT][NEUTRAL] Let me see here one moment.
[AGENT][NEUTRAL] Uh, it looks like it's
[CUSTOMER][NEUTRAL] Because sometimes it won't have the group on there.
[AGENT][NEUTRAL] Through the yeah that's through the employer. Do you need the group number and name?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Group number is 70056.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the group name.
[AGENT][NEUTRAL] And it's management management analysis and utilization.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Analysis and utilization.
[CUSTOMER][NEUTRAL] OK, perfect. Alright, I'll wait for that fax and then I can set that up and I'll call you back then if there's any other questions and then that would be the correct alternate ID the [PII] to use on his claims.
[AGENT][POSITIVE] Yes, ma'am, that is correct.
[CUSTOMER][POSITIVE] Alright perfect [PII]. I really appreciate your help and you have a great day.
[AGENT][NEUTRAL] You too, [PII]. Let me just get your facts for from you.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, sorry [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, you should have that in about 5 minutes.
[CUSTOMER][POSITIVE] Thank you, dear. Have a good day.
[AGENT][NEUTRAL] You too.