AccountId: 011433970860
ContactId: 48d011f4-bc6b-4474-bd7c-cb9b222b3af1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228699 ms
Total Talk Time (AGENT): 102054 ms
Total Talk Time (CUSTOMER): 90861 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/48d011f4-bc6b-4474-bd7c-cb9b222b3af1_20250110T19:38_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I am calling from, um, Laal Smile Dentistry, and I was just calling to get some information regarding patients benefits.
[AGENT][NEUTRAL] I can help with benefits. [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] OK, so the phone the number that I have here is.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh, the patient's name is [PII] and date of birth is.
[CUSTOMER][NEUTRAL] Oh gosh.
[CUSTOMER][NEUTRAL] The patient has been filled out their new patient form so I don't.
[CUSTOMER][NEUTRAL] Have uh.
[AGENT][NEUTRAL] Do you have his address?
[CUSTOMER][NEUTRAL] A date of birth.
[CUSTOMER][NEUTRAL] I do, uh, let's see here I have.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, bear with me please.
[CUSTOMER][NEUTRAL] The only thing he put was [PII].
[AGENT][NEUTRAL] OK, thank you. And I just need a callback number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] Sure, so it is uh [PII].
[AGENT][NEUTRAL] Thank you. It looks like the policy went into effect on [PII]. It is active.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] These policies have $500 per calendar year as the maximum. That's just a verification of the benefits, not a guarantee of payment and the policy covers basic.
[AGENT][NEUTRAL] Basic restorative and preventative services only, so there's no major coverage with these policies. It's, it's a very limited benefit policy. Um, I have a fact fact that I can send to you, Marina, if you'd be interested. Otherwise, um, it, it's, it just covers basic, basic restorative and preventative. Now.
[AGENT][NEUTRAL] The fee schedule that we use is the Carrington PPO fee schedule, but, but you're not you don't have to be a member of Carrington in order for the policy to pay out. So as long as the uh service is covered and he has available then we're fine.
[CUSTOMER][NEUTRAL] So we are not considered in network with any insurance carrier, so in that case, what let's say um is there like a set fee uh regardless if.
[CUSTOMER][NEUTRAL] We are a network or not a network with the fee schedule?
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] We don't really have a, we don't really have a network. Um, what we do is we just use the Carrington PPO fee schedule. You don't need to be in network with anyone in order in order for this policy to pay out. We do not have a network. It just pays that, that, uh, that benefit, um, and that's all that it pays. But as I mentioned before, it's a very limited policy.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it. And uh would it be possible to get a copy of that fee schedule as well?
[AGENT][NEUTRAL] Yes, um, I can send, what is your fax number, please?
[CUSTOMER][NEUTRAL] Sure, so it's [PII].
[AGENT][NEUTRAL] OK. Is there anything else at all that I can help with?
[CUSTOMER][POSITIVE] No, that'll be all thank you so much.
[AGENT][NEUTRAL] OK, I'll have this sent to you in just a minute. Um, if you have any questions, please decide, yes, uh-huh.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, I'm so sorry, uh, but will the claim billing address and payer ID be on the fax as well?
[AGENT][NEUTRAL] Uh, yes, yes, it is on there.
[CUSTOMER][POSITIVE] OK perfect that's all that's all the information I need.
[AGENT][POSITIVE] OK, well, thank you for contacting ATL. Have a very good day.