AccountId: 011433970860
ContactId: 376cbd99-0813-40c5-9a07-efb3a57b5a6b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 432519 ms
Total Talk Time (AGENT): 185600 ms
Total Talk Time (CUSTOMER): 175973 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/376cbd99-0813-40c5-9a07-efb3a57b5a6b_20250103T23:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm currently in the dental office right now. I'm trying to see whether I have coverage at this dental facility and what that coverage looks like.
[AGENT][NEUTRAL] OK, sure, we can take a look at that. [PII]. Let's see, just needing to see dental coverage and if the provider you're at will accept APL.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, really quick if you don't mind, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh, sure. It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] Policy number, yes, give me one second.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] It is 0251.
[CUSTOMER][NEUTRAL] 0213.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] Alright, just gonna verify some information really quick, [PII]. Can I get your date of birth, please?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] My mailing address is [PII].
[CUSTOMER][NEUTRAL] Uh, North Burton, New Jersey 07.
[CUSTOMER][NEUTRAL] [PII] I.
[AGENT][NEUTRAL] OK, um, I've got a different one. I've got one from, uh, [PII].
[CUSTOMER][NEUTRAL] Oh, I, yeah, I just moved. I'm sorry. It's [PII], yeah, [PII].
[AGENT][NEUTRAL] No, that's OK.
[AGENT][POSITIVE] I appreciate you verifying that so that does need to be updated correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, could you give me that, uh, current address again? It was [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And that's gonna be [PII].
[CUSTOMER][NEUTRAL] In the south building?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what was the city? I'm sorry.
[CUSTOMER][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] OK, thank you for that. Alright, I will get that updated for you. uh, last thing I need is the email address that we've got on file for you it looks like it is a Gmail account.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying that information. OK, and so you did say you're at the provider's office right now, is that right?
[CUSTOMER][NEUTRAL] Yes, yes, I'm currently here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so there's a couple things we can do, [PII]. So this plan that you're on it operates or participates in the Carrington PPO network. So this provider may or may not be in that network. However, it's not required that they're in that network. Um, if you would like, um, you can give them this information I can speak with them, but I can fax them a copy of like a breakdown of what is covered under your policy.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] So that they've got all of that information they will know what is and is not covered that might be a bit easier.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, sure, can you just hold on one moment please so I can go grab the doc go grab the doctor. OK, thank you.
[AGENT][POSITIVE] Of course, absolutely.
[AGENT][POSITIVE] Of course, yeah, definitely.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, great, I can give you my fax number. OK, sure, it's [PII].
[CUSTOMER][NEUTRAL] And is it, is it a PPO plan?
[AGENT][NEUTRAL] Um, it's so this plan, this plan participates in the Carrington PPO network.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] But it's not uh required to be in [PII].
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] What?
[AGENT][NEUTRAL] This plan participates in the Carrington PPM network.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] It's the utilization of that is not required though.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is it a PPO plan? Yes or no?
[AGENT][NEUTRAL] Yes, yes, it participates in the Carrington PPO.
[CUSTOMER][NEUTRAL] OK, so what is the fee for D1110?
[AGENT][NEUTRAL] That was 1110?
[CUSTOMER][NEUTRAL] 1110, yeah.
[AGENT][NEUTRAL] That would be considered preventative, so that is at 100%.
[CUSTOMER][NEUTRAL] OK, what's the fee schedule?
[AGENT][NEUTRAL] Again it participates in the Carrington PPO network.
[CUSTOMER][NEUTRAL] So can you tell me what the fee schedule is?
[AGENT][NEUTRAL] It would be through Carrington if you'd like I can give you their information. Are you in their network?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Sorry, this is, this is the doctor that you're currently speaking to. I don't know. Yeah, I'm the doctor. This is Doctor [PII]. Am I in network with this insurance?
[AGENT][NEUTRAL] OK, so that if you're not sure if you are, I wouldn't have that information. I can give you Carrington's information before I do that, um, I can go ahead and send you the fax back for the covered benefits.
[CUSTOMER][NEUTRAL] So we just
[CUSTOMER][NEUTRAL] Yeah, you got, but you guys, but you guys, OK, you can do that, but you guys keep bouncing us back and forth in between 22 sets of people. Yeah, we just got off the phone with Carrington and they told us to call you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Did they tell you whether or not that you're in network with them?
[CUSTOMER][NEUTRAL] No, they told us to call you, right, and that's when, that's why we just got transferred to you just now.
[AGENT][NEGATIVE] OK, yeah, that is frustrating.
[CUSTOMER][NEUTRAL] Yeah, so you guys are just bouncing us, you're bouncing us in between 22 sets of people.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] I understand, I understand. OK, but I, I, I understand now. OK, so yeah, I don't actually see who participates in the Carrington PPO network as this is APL we use their network for this plan, so I can send you that fax back it does have that information on it, but it does state that utilization of a provider within the Carrington network is not required, so you can still send those uh claims directly to us.
[CUSTOMER][NEUTRAL] OK, so that's what, that's what I was telling you earlier. I you'll pay out of pocket and then we'll just send the payment. I see, I see. OK, ma'am, thank you, bye bye.
[AGENT][NEUTRAL] OK, did you still want me to send this fax back to you?
[CUSTOMER][NEUTRAL] Yeah, send it to [PII].
[AGENT][NEUTRAL] OK, got it. uh, who's attention?
[CUSTOMER][NEUTRAL] Doctor [PII].
[AGENT][NEUTRAL] OK, sorry about the confusion there I was just as confused.
[CUSTOMER][POSITIVE] No problem.
[AGENT][POSITIVE] Alright thank you have a great rest of your day bye bye.
[CUSTOMER][NEUTRAL] Yep bye.