AccountId: 011433970860
ContactId: 12fa7d3d-404e-4007-882e-bb75dc446c40
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 847580 ms
Total Talk Time (AGENT): 201101 ms
Total Talk Time (CUSTOMER): 202484 ms
Interruptions: 2
Overall Sentiment: AGENT=0.1, CUSTOMER=-1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/12fa7d3d-404e-4007-882e-bb75dc446c40_20250217T18:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi Miss [PII], my name is [PII]. I have a new patient coming in, um, Wednesday, and I need to update some Carrington information please.
[AGENT][NEUTRAL] OK. All right, Ms. [PII], uh, can I please get your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name?
[CUSTOMER][NEUTRAL] We are seeing [PII], not [PII], sorry, [PII]. I'm singing the song instead of saying her name right.
[AGENT][NEUTRAL] OK. [PII].
[AGENT][POSITIVE] I, I love that song.
[CUSTOMER][NEUTRAL] Right?
[AGENT][NEUTRAL] OK. And then what is her um date of birth?
[CUSTOMER][NEUTRAL] [PII]. I have a policy number if you'd like to um confirm.
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] I have 02592800.
[AGENT][NEUTRAL] OK, let me look her up real quick.
[AGENT][POSITIVE] OK. I do show that [PII] does have an active policy. I'm gonna be, no, I'm gonna sing the song in my head all day today now.
[CUSTOMER][NEUTRAL] You can't do it without singing the song either, can you?
[CUSTOMER][NEUTRAL] I know, right, so see you.
[AGENT][NEUTRAL] And
[AGENT][NEGATIVE] Yeah. You're breaking my heart.
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] I got a singer, yes, OK, so she's been effective since when? I'm so sorry.
[AGENT][NEUTRAL] Really
[AGENT][NEUTRAL] That's OK. [PII], uh, I mean [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No, [PII].
[CUSTOMER][NEUTRAL] No, wait, when? [PII] [PII] fabulous. Is it single or is this a family plan?
[AGENT][NEUTRAL] January.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] It is individual coverage.
[CUSTOMER][NEUTRAL] Say that again.
[AGENT][NEUTRAL] Individual she's single on the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Single on the plan 02592800 and Carrington and the group number is 70054. She had the single come over here. I'm sorry it takes a hot minute and I will catch up to you. Carrington Network and then is this a PPO plan or is this a discount plan?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Uh, it's it, uh.
[AGENT][NEUTRAL] It's not a discount plan, so it must be PPO with Carrington um through APL.
[CUSTOMER][POSITIVE] Oh fabulous.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright and then the um claims address what's the [PII]?
[AGENT][NEUTRAL] That is going to be um [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's in [PII] City, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, there's another song.
[AGENT][NEUTRAL] And the zip code
[AGENT][NEUTRAL] I know we're gonna get loud on that one.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] In [PII]. OK, so this is in state order. Hang on just a second, we'll catch up to you real quick. [PII]. Show me [PII]. OK, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Got it right here, fabulous and then is there an individual deductible with this plan?
[AGENT][NEUTRAL] Let me look real quick. Let me pull up her uh facts back.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] And see, you're welcome.
[AGENT][NEUTRAL] She's got the low option, so let me look.
[AGENT][NEUTRAL] And this is just to verify her coverage. It's not a guarantee of payment. She has a $50 deductible.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] $50 not yet used or met.
[AGENT][NEUTRAL] Let me check on that for you and see if she's used anything this year.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] She still has her deductible left and she still has her $500 benefit for the year left.
[CUSTOMER][NEUTRAL] And you said 500?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Alrighty, and then how does the group coverage break down? Is it 180 50, or how does everything kinda settle on this?
[AGENT][NEUTRAL] OK, so she does not have, I'm gonna look and see if she's got, she's got basic.
[AGENT][NEUTRAL] Coverage only.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it breaks down um preventative expenses is 100 and then her basic is 80.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, what about endopperio oral surgery, which coverage category would those three come down in?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Do you have the procedure code, the CDT code?
[CUSTOMER][NEUTRAL] I do. Let me get my little cheat sheet out. Hang on, because I just for these situations endo try 3320.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 3320.
[AGENT][NEGATIVE] Is not covered.
[CUSTOMER][NEUTRAL] Alright, 0, and then how about uh let's do something easy 4910.
[CUSTOMER][NEUTRAL] That's pero perio maintenance.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] 4910. Let's look on this 4910.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Pero.
[AGENT][NEUTRAL] That's not the oral evaluation.
[CUSTOMER][NEUTRAL] Maintenance.
[CUSTOMER][NEUTRAL] Mm mm nope. That's a, that's a type of um cleaning.
[AGENT][NEUTRAL] Maintenance, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] It doesn't look like that's on this um fax back either.
[CUSTOMER][NEGATIVE] It's not OK and then.
[AGENT][NEUTRAL] I have a fax back I can fax to you and if there's a procedure that's not on it, then it's not covered.
[CUSTOMER][POSITIVE] Oh, that would be amazing.
[CUSTOMER][NEUTRAL] Not covered, OK, yeah, absolutely I'll take it from you if you, if you would be so kind as to um send it to. Would it have on there missing tooth cloths as well?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, it does. It does have a missing.
[CUSTOMER][POSITIVE] Fabulous.
[CUSTOMER][NEUTRAL] And then any frequency in history?
[AGENT][NEUTRAL] Clause.
[AGENT][NEUTRAL] Uh, let me look and see.
[CUSTOMER][NEUTRAL] Because if it has that, then I'll just say give me the fax, show me the fax.
[AGENT][NEUTRAL] He
[AGENT][NEUTRAL] Well she just says show me the facts on this policy she just uh got it on uh [PII], and there are no claims that have been submitted on it so there's no history at this time.
[CUSTOMER][POSITIVE] OK, excellent then I'm just gonna slide back and say would you like my fax number and then I will bid you a great day.
[AGENT][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, what is that?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Are you sure 217-235.
[CUSTOMER][NEUTRAL] 4271.
[AGENT][NEUTRAL] OK, I won't put you on a brief hold while I get that faxed together for you and I'll be right back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Come on.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.