AccountId: 011433970860
ContactId: 26e912d9-3b10-4234-a62f-e74a3c01faee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 173580 ms
Total Talk Time (AGENT): 92380 ms
Total Talk Time (CUSTOMER): 52798 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/26e912d9-3b10-4234-a62f-e74a3c01faee_20250128T19:29_UTC.wav
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[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Thank you for calling ATL. This is Ta[PII]How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is Ja[PII]I'm calling from Auburn Dental Center, and I just need to, uh, verify some dental coverage for a patient.
[AGENT][NEUTRAL] OK, can I help you, Ja[PII]What's the policy number?
[CUSTOMER][NEUTRAL] 02550516.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] 7,[PII]
[AGENT][NEUTRAL] [PII]9[PII]OK, do you have the schedule? If not, would you like to schedule a benefits faxed to you?
[CUSTOMER][NEUTRAL] Uh, um, with the schedule, it will give me a full total of the amount of the services or just, uh, percentages?
[AGENT][NEUTRAL] It depends on the policy.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] What, let me pull up the policy and verify the patient and then we can proceed, OK?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] And that meant 6 [PII].
[AGENT][NEUTRAL] OK, let me pull up the schedule for this.
[AGENT][NEUTRAL] Patient.
[CUSTOMER][NEUTRAL] A
[AGENT][NEUTRAL] Yeah, so this is, uh, based on a percentage and it covers preventive and basic only preventive is preventive is reimbursed at 100% of allowable. Basic is 80% of allowable.
[CUSTOMER][NEUTRAL] In an in and out of network?
[AGENT][POSITIVE] Yeah, in or out. So if you're not a part of the Carrington network, you'll still receive a benefit.
[CUSTOMER][NEUTRAL] In or out?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Paid to us or to the patient?
[AGENT][NEUTRAL] If there's an assignment of benefits on file and the claim is submitted by the provider, the reimbursement is to the provider.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and can I get that fax?
[AGENT][NEUTRAL] Mhm. What's your fax number?
[CUSTOMER][NEUTRAL] 77[PII]
[AGENT][NEUTRAL] [PII]hm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You should receive this within the next 5 to 7 minutes. Um, it's gonna be about 5 pages approximately including the cover page. Um, it will uh include the calendar year maximum, the calendar year deductible, um, the category category of expense.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, frequencies, common limitations, exclusions, uh, the claim's mailing address, payer ID number, and fax number, and then it'll list each procedure code that's covered under this policy. So if you do not see the procedure code, that means it's not covered.
[AGENT][NEUTRAL] Just so you know.
[CUSTOMER][POSITIVE] OK, perfect. OK, that's perfect.
[AGENT][POSITIVE] And it is on its way. Anything else I can help with today, Ja[PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, that will be all.
[AGENT][POSITIVE] Alrighty well thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye-bye.