AccountId: 011433970860
ContactId: 1ae96c6b-e640-4566-8263-c7e64c164714
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1984979 ms
Total Talk Time (AGENT): 578014 ms
Total Talk Time (CUSTOMER): 693410 ms
Interruptions: 9
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/1ae96c6b-e640-4566-8263-c7e64c164714_20250428T15:15_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, this is [PII] calling from Bo office. How are you doing today?
[AGENT][POSITIVE] I'm good, thank you. How about you, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] I'm also doing good. Thank you for asking, ma'am. Uh, I have a patient and I need dental benefits regarding this patient policy.
[AGENT][POSITIVE] OK, sure. I can assist you with dental benefits. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. The uh callback number is [PII].
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Uh, sorry?
[AGENT][NEUTRAL] The name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Uh, provider of his name.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, complete dental care clinics.
[AGENT][NEUTRAL] Only
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, I have a SSN number.
[CUSTOMER][NEUTRAL] Can you please find the patient by SSN number? Yeah, the [PII].
[AGENT][NEUTRAL] Oh, bear with me.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] All right. And may I have uh the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, sure. The name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you say you need dental benefits, and do you need this information given to you verbally or faxed over to you, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, you find this situation?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, you find this patient?
[AGENT][NEUTRAL] I did, yes. I, I need to know if you need the benefits verbally or facts.
[CUSTOMER][NEUTRAL] Uh, one moment, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Ma'am, uh,
[CUSTOMER][POSITIVE] If you do verbally, so then it's good for me.
[AGENT][NEUTRAL] Um, if you need the information verbal, I can go ahead and give you the information over the phone.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] But if you need something in writing, I can go ahead and fax over a breakdown of benefits. So I don't know which one is best for you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Ma'am, I need verbally.
[AGENT][NEUTRAL] OK, that's fine then. All right, so let's see, one moment, let me go ahead and pull the full breakdown and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[AGENT][NEUTRAL] And this is one of our basic dental policies. Um, this one doesn't have any major service.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] So endodontics, periodonics, prosthodontic repair, or surgery, crowns and bridges are not covered under this policy, OK?
[CUSTOMER][NEUTRAL] OK. Ma'am, yes ma'am, you said, uh, can you please repeat uh, please say slowly which is not covered in this plan?
[AGENT][NEUTRAL] Major service is not covered, including Ortho, endodonics.
[CUSTOMER][NEUTRAL] Ortho
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Periodonics.
[AGENT][NEUTRAL] Oral surgery.
[AGENT][NEUTRAL] Dentures or partials.
[AGENT][NEUTRAL] Um, some bridges.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Or surgery. So those are not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. You said orthoendoyio oral dentures, and implants are not covered, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. So, ma'am, uh,
[CUSTOMER][NEUTRAL] My first question is the provider to plan is in-network or out of network for this policy?
[AGENT][NEGATIVE] There's no network on this one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I also have a provider and you want?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, we don't need the MPI.
[AGENT][NEUTRAL] There's no network.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, you said?
[CUSTOMER][NEGATIVE] This is no a plan, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the timely filing limit for this policy?
[AGENT][NEGATIVE] We don't have timely filing limits.
[CUSTOMER][NEUTRAL] No time sir.
[CUSTOMER][NEUTRAL] And what about for coinsurance percentages?
[CUSTOMER][NEUTRAL] And uh.
[AGENT][NEUTRAL] OK, with this one, we have um preventative is cover 100%, radiograph FMS is cover at 80%, basic expense and basic restorative expenses cover at 80%.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] And this is same for out of network also?
[AGENT][NEUTRAL] There's no network, so it's the same for all.
[CUSTOMER][NEUTRAL] OK. So you said uh there is no network plan, right? There is no in-network and no out of network? No network plan. OK, OK. Got it. And do you accept assignments of benefits?
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] We do.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] The fee schedule name.
[AGENT][NEUTRAL] We pay on the usual and customary rates UCR so you use your schedule.
[CUSTOMER][NEUTRAL] Uh, UCR
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] But UCR is for uh out of network uh you said UCR is schedule name, right?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Ma'am, uh, yes, you said, uh,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You accept assignments of benefits and the fee schedule name is UCR, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Now, uh,
[CUSTOMER][NEUTRAL] Ma'am, uh, just to confirm once again, sorry for repeating. You said, uh, the treating provider is no network, right? There is no network.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Correct, there's no network.
[CUSTOMER][NEUTRAL] OK, thank you. Now, ma'am, uh, the policy type is calendar year, contracted year.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Calendar year.
[CUSTOMER][NEUTRAL] And the policy effective date?
[AGENT][NEUTRAL] OK, let me get that for you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK. And is there any termination date?
[AGENT][NEUTRAL] No, there's no termination date as of right now.
[CUSTOMER][NEUTRAL] And what, what about for annual max benefits?
[AGENT][NEUTRAL] OK, the calendar year maximum is $500 with the $50 deductible and deductible does not apply to preventatives.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, 500 benefit, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And what about for remaining?
[AGENT][NEGATIVE] She has not used the benefits as of today. Well, he has not used the benefit as of today.
[CUSTOMER][NEUTRAL] OK. So he has 500, he has 500, all right?
[AGENT][NEUTRAL] Available.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Mm, no.
[CUSTOMER][NEUTRAL] And what about for uh deductibles for individual or family?
[AGENT][NEUTRAL] It's 50.
[CUSTOMER][NEUTRAL] $50.
[AGENT][NEUTRAL] Or 150 if it's a family.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. For family 150, right? And nothing has been met.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And deductible applies only for not for basic only, uh sorry, it applies only for basic, right?
[AGENT][NEUTRAL] For radiograph and basic, not for the preventative.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh for diagnostic, it applies or not?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, sorry, uh, deductible applies to diagnostic and basic, uh, right?
[AGENT][NEUTRAL] Um, yes, uh, anything that is not preventative, it will apply that deductible. So preventatives are, um, oral evaluation is gonna be the wean, it's gonna be the comprehensive evaluation, and it's gonna be profies, fluorides, and sealants.
[AGENT][NEUTRAL] Those are all under preventative. So anything that is not under the preventative is gonna be under basic or basic expense, which it, it applies.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, ma'am, uh, now, is there any waiting period, any missing tooth cloth, any pending claim?
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] There
[AGENT][NEUTRAL] OK, there's no waiting period because it's just a basic policy.
[AGENT][NEUTRAL] Um, it does have a missing tooth cloth, but it doesn't have any major service.
[AGENT][NEGATIVE] So it doesn't really apply.
[CUSTOMER][NEUTRAL] So, no missing tooth cloth, right?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And any pending claim?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] No, no pending claims.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK. Now, ma'am, uh, ma'am, uh, the annual max applies to these services. It applies to only uh preventative and basic, right?
[AGENT][NEUTRAL] No.
[AGENT][POSITIVE] It applies to everything. The maximum benefit applies to everything.
[CUSTOMER][NEUTRAL] We're gonna
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, ma'am, I have a course and a frequential percentage for that cost.
[AGENT][NEUTRAL] Um, bear with me just a minute.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] I, I'll give you one by one or all at once.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] One by one.
[CUSTOMER][NEUTRAL] OK, thank you. Now, uh 0220.
[AGENT][NEUTRAL] OK one moment.
[AGENT][NEUTRAL] OK, 0220, that's on the basic.
[AGENT][NEUTRAL] Which is 80%, there's no limitation.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. And 0274?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, 7204, that's limited to one by weight and X-ray procedures in any combination of 270, 272 and 274 per 12 month period period.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And that one is gonna be under preventative.
[CUSTOMER][NEUTRAL] Once for 12 months, right?
[AGENT][NEUTRAL] Yes, one for 12 month period and it's combined with 270, 272, and 274.
[CUSTOMER][NEUTRAL] OK. And what
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, got it, ma'am. Thank you so much. Now, 0431.
[AGENT][NEUTRAL] You said 0431, that's not covered. Any period or endo are not covered.
[CUSTOMER][NEUTRAL] And what about for 0460?
[AGENT][NEGATIVE] That's not cover.
[CUSTOMER][NEUTRAL] That you
[AGENT][NEUTRAL] Or, give me just a second. Oh, that one, yeah. Bear with me. You said 0460?
[CUSTOMER][NEUTRAL] OK. Now, 0.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, 0460.
[AGENT][NEUTRAL] Pub, um, chess.
[AGENT][NEUTRAL] Yeah, that one is under basic.
[AGENT][NEUTRAL] No limitation on that one.
[CUSTOMER][NEUTRAL] OK. And what about, OK, now 0330.
[AGENT][NEUTRAL] 0330.
[CUSTOMER][NEUTRAL] that.
[AGENT][NEUTRAL] OK, so that's gonna be limited to one X-ray procedure in any combination of 210, 277, or 330 per five-year period. So once every 5 years.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK. And it is uh under or basic?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's on the Radiograph FMX which is 80%.
[CUSTOMER][NEUTRAL] 80%, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Now, 0120.
[AGENT][NEUTRAL] 0120. OK, so that one is going to be under preventative.
[AGENT][NEUTRAL] And for that one we have, let's see one moment.
[AGENT][NEUTRAL] Limited to two oral evaluation procedures and any combination of 120, 140, 150, or 160 for 12 month period.
[CUSTOMER][NEUTRAL] OK, 2 past 12 months. OK, thank you. Now, 0140.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 0140. So that's gonna be under the same thing. It's combined 120, 140, 150, and 160.
[CUSTOMER][NEUTRAL] OK. So it's a frequency with other exams, right?
[AGENT][NEUTRAL] Mhm, yeah, share frequency with those with 120, 140, 150, and 160.
[CUSTOMER][NEUTRAL] OK. And uh
[CUSTOMER][NEUTRAL] OK. And ma'am, uh, there's a question for 0140, like uh can uh 0140 be performed with other procedures? It will be yes or no?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yes. OK. Thank you. Now, fluoride 1206.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] 1206, that one is not listed.
[CUSTOMER][NEUTRAL] Uh, you mean not covered, right?
[AGENT][NEUTRAL] If it's not listed, more than likely it's not covered, um, so I don't see that one listed on the schedule.
[CUSTOMER][NEUTRAL] Um, OK, ma'am, one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Now 11:10.
[AGENT][NEUTRAL] OK, so that's the pulsing.
[AGENT][NEUTRAL] That's gonna be under preventative, which is 100%, and that was, is once every 6 months.
[CUSTOMER][NEUTRAL] OK. 4910.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 4910 is not covered.
[CUSTOMER][NEUTRAL] Not covered, OK.
[CUSTOMER][NEGATIVE] Uh, no.
[CUSTOMER][NEUTRAL] 3310
[AGENT][NEGATIVE] 3310 is not covered.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Ma'am, uh, crown is also not for, right?
[AGENT][NEUTRAL] Correct, it's not covered.
[CUSTOMER][NEUTRAL] OK. One moment.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] No, 6010.
[CUSTOMER][NEUTRAL] But we are going to see here.
[AGENT][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And orthodont is also not covered, ma'am in this plan, right?
[AGENT][NEUTRAL] Mm, correct, not covered. Mhm.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, now, uh, 9110.
[AGENT][NEUTRAL] 9110. Let's see.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so that's palliative. Uh, that's gonna be under basic and there's no limitation on that one.
[CUSTOMER][NEUTRAL] OK. 90 to 22.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEGATIVE] That one is not covered.
[CUSTOMER][NEUTRAL] OK, 90 to 23.
[AGENT][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 90 to 39.
[AGENT][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] 9944.
[AGENT][NEUTRAL] 9944 is not covered.
[CUSTOMER][NEUTRAL] OK. Now, uh 9430.
[AGENT][NEGATIVE] 9430 is not covered.
[CUSTOMER][NEUTRAL] 7310.
[AGENT][NEUTRAL] 7310 is not covered.
[CUSTOMER][NEUTRAL] OK. One moment, ma'am. Ma'am, uh, you said, uh, oral surgery is also not covered, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Ma'am, uh, dentures is also not covered. Is this correct?
[AGENT][NEUTRAL] The what? I'm sorry?
[CUSTOMER][NEUTRAL] Uh, dentures, dentures, the code 5110.
[AGENT][NEGATIVE] No, dentures are not covered.
[AGENT][NEGATIVE] No, those are not covered.
[CUSTOMER][POSITIVE] OK, ma'am. Thank you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] about it
[CUSTOMER][NEUTRAL] Now, uh, the code is 1351.
[AGENT][NEUTRAL] 1351, 1 moment, let me see.
[AGENT][NEUTRAL] OK, 1351 is gonna be under preventative. It does have an age limitation.
[AGENT][NEUTRAL] And it looks like it's gonna be a maximum of 1 procedure every 36 months limited to dependent children under the age of [PII], and application made to the permanent molar teeth only.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK. Thank you so much, uh, permanent molar. OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it is uh age limitation like up to [PII], so this question is
[CUSTOMER][NEGATIVE] Not eligible for this, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, thank you. Now my next question next code is 2392.
[CUSTOMER][NEUTRAL] with a new policy.
[AGENT][NEUTRAL] 2392 that is under basic restorative, which is 80% and it's gonna be replaced assisting only if in place for 24 months.
[CUSTOMER][NEUTRAL] Onces for 24 months, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And ma'am, uh, our posterior composites downgraded to amalgam?
[AGENT][NEUTRAL] We don't downgrade.
[CUSTOMER][NEUTRAL] No longer, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Now, next code is, uh,
[CUSTOMER][NEUTRAL] 4263
[AGENT][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] OK. And uh 435-5.
[AGENT][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 4341.
[CUSTOMER][NEUTRAL] I
[AGENT][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] 4346
[AGENT][NEUTRAL] And theonics or periodontics are not covered, so not covered.
[CUSTOMER][NEUTRAL] OK. OK, thank you. One moment.
[AGENT][POSITIVE] You're welcome, sure.
[CUSTOMER][NEUTRAL] OK, now, uh, yeah, done with all, ma'am, uh, is there any, can you please check for history for this patient?
[AGENT][NEUTRAL] Sure. One moment.
[CUSTOMER][NEUTRAL] Uh, like, is there any history for Pennomax?
[AGENT][NEUTRAL] OK, bear with me, let me go to the history page.
[CUSTOMER][NEUTRAL] Yeah, ma'am, sure.
[CUSTOMER][NEUTRAL] What.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] I have a 2:10 on [PII].
[AGENT][NEUTRAL] And then I have a comprehensive evaluation. 210. I have a 210 and a 150 on [PII]. Those are the only two listed.
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] [PII]. Uh, yeah, right?
[AGENT][NEUTRAL] Under the history.
[AGENT][NEUTRAL] [PII]. Correct, yes. Mhm.
[CUSTOMER][NEUTRAL] And a chef you can see with pano, right?
[AGENT][NEUTRAL] Um, the ones that share frequency with panel, yeah, it's the 210, 277, and 330. So yes, the 210 is sharing frequency with panel.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, and, uh, also there is a history for, uh, 0905-202440150, right?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK, thank you. One moment. And ma'am, uh,
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] 40,150.
[CUSTOMER][NEUTRAL] Uh, the frequency is 2 + 12 months, right?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 0150 is going to be under, bear with me, let me go back to the benefit page. OK, so again, on the 0150 is combined. It's a 2 for 12 month period, 120, 140, 150 or 160.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK. Thank you so much for confirming and uh
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Now, ma'am, uh, can you please spell your name?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] My
[CUSTOMER][POSITIVE] OK, thank you so much. And your reference number for this patient.
[AGENT][NEUTRAL] We don't have reference numbers, you can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, thank you so much, sir. Have a good day. Bye for now. Like I also.
[AGENT][NEUTRAL] Mhm, yeah, mhm.
[CUSTOMER][NEUTRAL] So, uh, I, I need a fax benefit. Can you please send a fax for this patient?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, I can, um, no, you have to wait for me to send it before I let you go. Is that OK?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, ma'am, please send the fax.
[AGENT][NEUTRAL] OK, what is the fax number?
[CUSTOMER][NEUTRAL] Yeah, the fax number is [PII].
[CUSTOMER][NEUTRAL] Do you see it.
[AGENT][NEUTRAL] OK, that's [PII].
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] Yeah, ma'am. That's correct. And, uh, in how many minutes, uh, I get, uh, fax?
[AGENT][NEUTRAL] It's a few minutes. Um, let me go ahead and send it right now. Do you mind holding for me?
[CUSTOMER][POSITIVE] Yeah, yeah, ma'am. I'm waiting for you.
[AGENT][NEUTRAL] OK. Thank you. One moment. OK, I'm gonna go ahead and send it right now.
[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.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Mr. [PII]. OK, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I'm gonna help you with today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, ma'am, uh, just to confirm, uh, you said the few schedule name for this patient is UCR. This is correct?
[AGENT][NEUTRAL] Yeah, well, this one, if the provider participates with Carrington, they can use their fee schedule. If they don't, then it's gonna pay under the UCR.
[CUSTOMER][NEUTRAL] Oh, OK. I got it. You, uh, Carrington fee for in-network and for out of network, it will be used here, right?
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] She
[CUSTOMER][POSITIVE] Carrington fee. OK. Thank you so much. And ma'am, uh, you, uh,
[AGENT][NEUTRAL] Yeah. Mhm.
[CUSTOMER][NEUTRAL] You have a question like, uh, I'm asking that when I ask for provider is in or out of network.
[AGENT][NEUTRAL] We have no network. So basically, if you're not with Carrington, then you cannot use their fee schedule. So it's not based on, yeah, we don't have any network and that's why I was saying we don't have any network. Mhm yes.
[CUSTOMER][NEUTRAL] OK, OK, OK.
[CUSTOMER][POSITIVE] Yeah, yeah, yeah. Yes. Yes, yes, yes, yes. Got it, got it. Uh, because I'm just to confirm because of free schedule. OK, thank you so much, sir.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Mhm. You're welcome. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] And I get in
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No, sir. I'm done with my inquiries. And you said uh I'll be have my effects in just a minute. So, thank you so much for that.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] Yes. All right. You're welcome. Have a good day, [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] Same to you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I was a double.