AccountId: 011433970860
ContactId: 3d5360f0-b638-4b56-97b5-33450f65ac52
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 272739 ms
Total Talk Time (AGENT): 104799 ms
Total Talk Time (CUSTOMER): 131069 ms
Interruptions: 1
Overall Sentiment: AGENT=2.8, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/3d5360f0-b638-4b56-97b5-33450f65ac52_20250116T17:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from a provider's office, Comfort Dental North Academy, I need to just try to call and uh verify, uh, a patient's coverage, uh, and also want to check on our status with you guys.
[AGENT][NEUTRAL] OK, as in like in-network or out of network?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK. Well, I'll be more than happy to help you with the eligibility and the coverage. And [PII], may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] Yeah, of course, so uh callback number is gonna be [PII].
[CUSTOMER][NEUTRAL] Uh, patients ID number that we have on file is [PII].
[AGENT][POSITIVE] Thank you and I'll be, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure, so, um, the, so the, the person we have here is not the primary. Do you want her, her info or the primaries?
[AGENT][NEUTRAL] Um, the, the patient, whoever the patient is, is fine. It doesn't have to be the primary.
[CUSTOMER][NEUTRAL] OK, perfect. So patient's name is gonna be uh first name [PII] Last name [PII] Her birthday is [PII].
[AGENT][NEUTRAL] Alrighty, and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII].
[AGENT][NEUTRAL] And did you need a copy of the fax back sent over to you, or you have particular questions?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Um, honestly, I definitely would like the facts back.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, do you want a fax number or email?
[AGENT][NEUTRAL] And what's this? Mhm.
[CUSTOMER][NEUTRAL] OK, it'll be 719.
[CUSTOMER][NEUTRAL] 522
[CUSTOMER][NEUTRAL] 0810.
[AGENT][NEUTRAL] Thank you, should I put attention [PII]?
[CUSTOMER][NEUTRAL] Yeah, absolutely, um, let's see, uh, only other main question I've got would be, uh, what, uh, like what network you guys run this through what fee schedule?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So this actually isn't on a network. Um, we, we work with [PII], um, but this is not, this doesn't have a um a network like a PPO or HMO. It's just a um list of cover codes. If it's not on this list, it wouldn't be covered, but it goes by percentage and UCR.
[CUSTOMER][POSITIVE] Got you OK
[CUSTOMER][NEUTRAL] Alright, that is good to know then, um, and I guess I just wanna verify if possible uh that we have the correct claims address and payer ID for you guys. What we have on file uh is gonna be a claims address of [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Perfect, uh, and then I had a payer ID of 60801.
[AGENT][POSITIVE] Mhm, that's correct as well.
[CUSTOMER][POSITIVE] All right, perfect.
[CUSTOMER][NEUTRAL] All right, double check.
[AGENT][POSITIVE] So I am sending the um fax back over to you now. So you should be receiving that shortly. Um, I just pressed send, um send, so it's on the way to you. And then was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] See if
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Um, so, uh, yeah, uh, uh, I think you were mentioning that might need to be transferred, but I definitely wanted to check and.
[CUSTOMER][NEUTRAL] Or well, sorry, yeah, you, you, you told me there's no network, so yeah, think, think we good.
[AGENT][NEUTRAL] Oh, yes, OK.
[AGENT][NEUTRAL] You sure?
[CUSTOMER][NEUTRAL] Uh, oh, ref uh call reference number always need one of those.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. So that's [PII], the [PII] to my last name is [PII], and then today's date.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Right
[AGENT][POSITIVE] Alrighty [PII]. Well, thank you so much for calling APL. Was there anything else I can assist with?
[CUSTOMER][POSITIVE] That'll do it for today. Thank you, [PII].
[AGENT][POSITIVE] You're welcome and have a good day.
[CUSTOMER][POSITIVE] You as well thanks.
[AGENT][POSITIVE] Thank you. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.