AccountId: 011433970860
ContactId: 16ba8326-59b7-46e2-b6d3-557353c117ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 366559 ms
Total Talk Time (AGENT): 119639 ms
Total Talk Time (CUSTOMER): 130393 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/16ba8326-59b7-46e2-b6d3-557353c117ea_20250217T19:57_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] with Anderson and Floyd Dentistry. I am needing you guys to send us our the fee schedule for you guys. Um, I called before and you guys sent us, um, the wrong thing. We were looking for the uh fee schedule, um, but you guys sent us information about you guys. We're I'm needing to know the UCR of what you cover for fillings, so, um, I, I can tell a patient exactly how much he is going to pay.
[AGENT][NEUTRAL] What's your policy number, [PII]?
[CUSTOMER][NEUTRAL] Yes, it is 2 I'm sorry 02589583.
[AGENT][NEUTRAL] Can I have a callback number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the member's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] birthday is [PII].
[AGENT][NEUTRAL] Thank you, and you said that someone sent over a schedule did was it a dental schedule because that's the only thing that we can fax over. Did it break down like the maximum yearly, the yearly max, the deductible, there's.
[CUSTOMER][NEUTRAL] So it
[CUSTOMER][NEGATIVE] It sent us uh let's see, it sent me information of what you guys cover that's 80% of UCR, but it doesn't give me the amount. It tells me like frequency for exams, bye wings, crowns, bridges, partial, stuff like that, and then it says schedule for covered dental services and procedures, but it doesn't give me the amount like what you guys are gonna cover billing.
[AGENT][NEUTRAL] It's not, it's based on like user and customary user and customary amount like whatever your user and customer, your UCR amount is we will pay the percentage of 100% towards preventative, basic 80%, major 40%.
[CUSTOMER][NEUTRAL] OK, would I be able to give you guys a code and then have you guys tell me exactly how much you guys pay for that?
[AGENT][NEUTRAL] And what is your procedure code?
[CUSTOMER][NEUTRAL] Um, he's getting a lot of fillings done. Um, let me give you this one first D2392.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] What's your um zip code?
[CUSTOMER][NEUTRAL] Zip code [PII].
[CUSTOMER][NEUTRAL] And we charge 190.
[AGENT][NEUTRAL] And you said D2.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Give me your zip code one more time, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] It's not pulling up for the zip code, you said [PII].
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] May I place you on a brief hold?
[CUSTOMER][NEUTRAL] Yep.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, how are you doing?
[AGENT][NEUTRAL] The [PII], I had forgot who I called for a moment. [PII], I need some assistance with something, so I'm on the UCR page, the UCR screen, right?
[AGENT][NEUTRAL] And I'm trying to find out this customer, this this provider wants to know how much we'll pay for a particular procedure.
[AGENT][NEUTRAL] So when I put her zip code in, it's [PII]. So which numbers of the zip code I put in?
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] I did, and it says.
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] She want a filling.
[AGENT][NEUTRAL] Uh I see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you and I, I think I was spending the wrong procedure code or I didn't put the INQ in the action box.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] Bye. Have a good day.
[AGENT][POSITIVE] Thank you for holding and give me that code again.
[CUSTOMER][NEUTRAL] D 2392.
[AGENT][NEUTRAL] So we will pay up to $281.
[CUSTOMER][NEUTRAL] For that code
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $289. OK, would I 8281. OK, can I give you a few more other codes to double check?
[AGENT][NEUTRAL] 81, 281.
[AGENT][NEUTRAL] What's the next code?
[CUSTOMER][NEUTRAL] Um, let's see D2330.
[CUSTOMER][NEUTRAL] giving you a call
[AGENT][NEUTRAL] Up to 183.
[CUSTOMER][NEUTRAL] 183. OK, I have two more D2.
[CUSTOMER][NEUTRAL] Um, sorry, D2331.
[AGENT][NEUTRAL] Up to 234.
[CUSTOMER][NEUTRAL] 234 and then I have one more D239.
[CUSTOMER][NEUTRAL] Uh, one.
[AGENT][NEUTRAL] Up to 2:14.
[CUSTOMER][POSITIVE] 214. OK, thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Nope, that is it.
[AGENT][POSITIVE] Thanks for calling APL and have a great day.
[CUSTOMER][NEUTRAL] You too bye.