AccountId: 011433970860
ContactId: 2332cc30-eb18-4d92-b60e-c0afa028be2c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 375369 ms
Total Talk Time (AGENT): 131150 ms
Total Talk Time (CUSTOMER): 116573 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/2332cc30-eb18-4d92-b60e-c0afa028be2c_20250610T16:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, how are you? Thank you for answering. I was trying to um see if um.
[CUSTOMER][NEUTRAL] We are in network with this insurance company for 2 different patients that are coming in for tomorrow.
[AGENT][NEUTRAL] OK, can I get your name and a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Um, sure, my name is [PII] and my callback number will be [PII].
[AGENT][NEUTRAL] And can I get one of the policy numbers?
[CUSTOMER][NEUTRAL] Um, yes, give me one second, I'm just gonna pull it up.
[CUSTOMER][NEUTRAL] OK, I have um 02635081.
[AGENT][NEUTRAL] OK give me just one moment while I look that up.
[AGENT][NEUTRAL] And are you wanting benefits as well or just um eligibility?
[CUSTOMER][NEUTRAL] Um, yeah, once I confirm.
[CUSTOMER][NEUTRAL] Um, if they, if we're in network we're out of network, then I'm gonna ask for eligibility and benefits for this patient for both.
[AGENT][NEUTRAL] OK. Uh, can I get the patient's name and date of birth?
[CUSTOMER][POSITIVE] Yeah it will be um [PII].
[CUSTOMER][NEUTRAL] Last name [PII].
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, her date of birth is.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] I'm showing that this patient is active with an effective date of [PII].
[AGENT][NEUTRAL] And let me see her policy.
[AGENT][NEUTRAL] Um, and so, and this is for dental services, correct?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, um, so this policy doesn't do in and out of network, although it does participate in the Carrington PPO network. Um, it's not required as long as it's services that are covered under their policy, we will, um, we will honor the payments.
[CUSTOMER][NEUTRAL] OK, so we're out of network.
[AGENT][NEUTRAL] Yes. Would you like the fax back of all of the benefits that are on their policy?
[CUSTOMER][POSITIVE] Yes, please if you don't mind.
[AGENT][NEUTRAL] OK, give me just one moment.
[CUSTOMER][NEUTRAL] And we can use the same information because it seems like the other patient is um her husband.
[AGENT][NEUTRAL] Oh, let me see.
[AGENT][NEUTRAL] Um, and what is the name and date of birth?
[CUSTOMER][NEUTRAL] For the husband, uh first name, [PII].
[CUSTOMER][NEUTRAL] And last name
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, you can use the same uh the same back back.
[AGENT][NEUTRAL] Because they will have the same benefits.
[CUSTOMER][NEUTRAL] OK, um, and what would be the coverage since we're out of network for 2 different codes that we're gonna use for their first visit, I'm sorry, 3 different codes.
[AGENT][NEUTRAL] So we go by percentage of allowable for this policy?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Um, it's a 100% of allowable for preventative expenses, 80% for radiograph, FMX, basic and basic restorative. And this is a basic policy, so no major services will be covered under this policy.
[CUSTOMER][POSITIVE] Got it thank you. OK, let's see.
[CUSTOMER][NEUTRAL] OK, so and the name of the insurance is APL or it will be Carrington?
[AGENT][NEUTRAL] It will be APL.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] And this is the best phone number to get in contact with the company.
[AGENT][NEUTRAL] Right, and then all of our um.
[AGENT][NEUTRAL] Claim information, including our payer ID will be on this faxed back.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] And who would you like the attention to go to? Oh, go ahead.
[CUSTOMER][NEUTRAL] And on the fastback.
[CUSTOMER][POSITIVE] No worries, um, on the fax and on the fax back we're also gonna get the frequencies and limitations for the plan.
[AGENT][NEUTRAL] Um, it does show frequencies, um, and it shows, uh, the exclusions, yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Got it thank you.
[CUSTOMER][NEUTRAL] OK, and do you need my fax number?
[AGENT][NEUTRAL] Uh, yes, whenever you're ready.
[CUSTOMER][NEUTRAL] OK, it will be 804.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and to confirm, I have [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I just sent that fax back over to you. You should receive it within 5 to 10 minutes.
[CUSTOMER][POSITIVE] Perfect thank you.
[CUSTOMER][NEUTRAL] And I just need your name and a reference number please.
[AGENT][NEUTRAL] OK, so we don't do call reference numbers, but you can use my name and last initial in today's date. So [PII], and today's date.
[CUSTOMER][POSITIVE] Perfect thank you.
[AGENT][POSITIVE] Great, thank you so much for calling ATL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You as well bye bye now.
[AGENT][NEUTRAL] OK.