AccountId: 011433970860
ContactId: 41869a7c-e594-4860-a206-5dfa337bdf4b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 679299 ms
Total Talk Time (AGENT): 152620 ms
Total Talk Time (CUSTOMER): 186376 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/41869a7c-e594-4860-a206-5dfa337bdf4b_20250519T21:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, I have a question about um some dental, my dental coverage um for getting a dental procedure.
[AGENT][NEUTRAL] OK, can I get your name and a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, my name's [PII] and my callback number is [PII].
[AGENT][NEUTRAL] And what's your policy number?
[CUSTOMER][NEUTRAL] Policy number is 02539179.
[AGENT][NEUTRAL] Alright, one moment while I look that up for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and can I get you to verify your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your mailing address and phone number.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] and then same number [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] And what questions did you have?
[CUSTOMER][NEGATIVE] Yeah, so I just got out of my dentist's office and they're saying that I need a crown. It's my first crown I've ever needed, and y'all are, um, like they put it in through my insurance and everything and it's basically showing I'm having to pay basically full price or only covering $30 so it's gonna be.
[CUSTOMER][NEUTRAL] $1,405 but if I were to just pay out of pocket, it was $1,432.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I just don't understand, like, y'all not cover that? Why is that not covered? Because I'm pretty sure I got like the best coverage I could when I signed up for my dental insurance.
[AGENT][NEUTRAL] Alright, let me check and see.
[AGENT][NEUTRAL] I'm gonna pull up your policy real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said it was for a crown, correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEGATIVE] It only took off like close to 30 bucks.
[CUSTOMER][NEUTRAL] And I have, I signed up for the most coverage that was allotted to me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me a second.
[AGENT][NEUTRAL] Sorry, give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] I'm having to go through each procedure cause. Give me just a moment while I look it up for you.
[CUSTOMER][NEUTRAL] OK, I have the codes like they gave me like uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Plan for it or whatever and I have the codes that they have on it if you would like them.
[AGENT][NEUTRAL] OK, what are the, yeah, that would be helpful.
[CUSTOMER][NEUTRAL] So two number 29, the code is N4119 and it's like description is all serve crown seat.
[AGENT][NEUTRAL] You said one, what was just the numbers?
[CUSTOMER][NEUTRAL] 4119.
[CUSTOMER][NEUTRAL] Which that one I don't think.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Allotted to, I think it's free kinda.
[CUSTOMER][NEUTRAL] But then I have 3 other codes.
[AGENT][NEUTRAL] OK, yeah, because I'm not seeing that one.
[CUSTOMER][NEUTRAL] OK, D, the letter D, and then it's 2740.
[AGENT][NEUTRAL] 2740.
[AGENT][NEUTRAL] I'm not seeing that one either.
[AGENT][NEUTRAL] What are the other two.
[CUSTOMER][NEUTRAL] And then the other and that one.
[CUSTOMER][NEUTRAL] D0220
[CUSTOMER][NEUTRAL] Like it has like code, description fee, all that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Then.
[CUSTOMER][NEUTRAL] You're not seeing that one either, are you?
[AGENT][NEUTRAL] Let me double check.
[AGENT][NEUTRAL] I do have that one. It is showing as a basic.
[AGENT][NEUTRAL] Which means that it should be 80% of allowable, and it's up to them on what the allowable expenses is because it goes based off of their UCR.
[AGENT][NEUTRAL] So it's 80% of allowable, so.
[CUSTOMER][NEUTRAL] OK, but really the one.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The one the D 2740, that's the one it's 1000.
[CUSTOMER][NEUTRAL] It's like over $1000 so it's the only one really that the one that you can't find, uh, that's the one I need covered.
[AGENT][NEUTRAL] Yeah, that is the one that I'm not seeing on here.
[CUSTOMER][NEUTRAL] Like the other one's like 30 bucks.
[CUSTOMER][NEUTRAL] So do y'all just not cover it or like what's?
[AGENT][NEGATIVE] It doesn't look like it for this one.
[CUSTOMER][NEUTRAL] What does that mean you can't find?
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Because that, that's the code for a crown.
[AGENT][NEUTRAL] Yeah, and I'm not seeing that one on here.
[CUSTOMER][NEGATIVE] I'm like, why would that not be covered? And there's not gonna be an alternative that's under $1000.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So what, like what's the
[AGENT][NEUTRAL] And I'm not seeing that, um.
[AGENT][NEUTRAL] Do you know if you found your provider through the Carrington network or if they use the Carrington network?
[CUSTOMER][NEUTRAL] It does say Carrington, yes, on my little.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] On your policy card. OK. Um, it's not covered.
[CUSTOMER][NEUTRAL] Card.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But since you do go through the Carrington network, there may be a discount that I am unable to see since I'm not through Carrington.
[AGENT][NEUTRAL] So you might want to call, let me see.
[CUSTOMER][NEUTRAL] OK, so they don't cover freaking crowns. Well, what's the number? I don't have a number for Carrington.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um I can look it up for you. Give me just a moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] OK. The number for Carrington is [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] 400.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And I would check and see
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes ma'am, and I would call and see if they offer any discounts since you are using a provider within their network.
[CUSTOMER][NEUTRAL] OK, my provider is in the number and what's your name?
[AGENT][NEUTRAL] Mhm. My name is [PII].
[CUSTOMER][NEUTRAL] What's your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK all right thank you.
[AGENT][NEUTRAL] All right. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] OK, thank you so much for calling. Oh, go ahead.
[CUSTOMER][NEGATIVE] Just so you know, this is the worst insurance I've ever had, and this is like my 4th time calling for medical and dental.
[AGENT][POSITIVE] I'm so sorry to hear about that.
[CUSTOMER][NEUTRAL] And I've, yeah, so just.
[CUSTOMER][NEGATIVE] I'll let you know the coverage is horrible.
[AGENT][POSITIVE] I'm so sorry to hear that you're having issues with the coverage.
[CUSTOMER][NEUTRAL] Yeah, I am.
[AGENT][NEUTRAL] Definitely call Carrington and see if they have any extra discounts that they can provide since you're using an in-network provider.
[CUSTOMER][POSITIVE] I, I am, I'm going to. I appreciate it.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] All right, thank you so much. Have a great day.
[CUSTOMER][POSITIVE] Thanks.