AccountId: 011433970860
ContactId: 514dae91-e849-4adc-8078-34608d3c7f33
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 169000 ms
Total Talk Time (AGENT): 54413 ms
Total Talk Time (CUSTOMER): 101524 ms
Interruptions: 2
Overall Sentiment: AGENT=2.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/514dae91-e849-4adc-8078-34608d3c7f33_20250206T14:05_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I didn't
[CUSTOMER][NEUTRAL] Um, yes, ma'am, I have a question, um.
[CUSTOMER][NEUTRAL] So we um OK back up so I'm calling from a provider's office and I called yesterday to kinda get like a benefit breakdown um it was faxed to us but it's no percentages it's just uh like a dollar amount, um.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK. Uh, may I have your name? I'm so sorry.
[CUSTOMER][NEUTRAL] It's OK. My name is [PII]. Mhm.
[AGENT][NEUTRAL] [PII], thank you. And what is your callback number if we were disconnected please?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And [PII], what is that policy number?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Um, it's 613-676.
[AGENT][NEUTRAL] OK, thank you. And verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] First name is [PII], last name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you so much for the information, [PII]. And yes, ma'am. This policy pays on a fee schedule. Um, the amount that you see to the very right, that's the amount that we pay for that particular procedure code.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so I'm, I guess I'm just a little confused cause I've never um.
[CUSTOMER][NEUTRAL] Gotten one like like this before, so we go by percentages when we enter in the um insurance in the system like it says like preventive basic major, you know, like some plans are 180, 50.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, you know, uh, surgical extractions are, most of the time they're like 50 or 80 and then dentures cause all we do is extractions and dentures, um, cause she informed me there's no implant coverage. Um, so I would need like a percentage, um.
[CUSTOMER][NEGATIVE] On her plan because there's no way for us to put in like a dollar amount.
[CUSTOMER][NEUTRAL] So is that
[CUSTOMER][NEUTRAL] I guess I'm just a little confused so I know it's out of network because we're not in network with them.
[AGENT][NEUTRAL] With this particular plan, there's no percentages, um, we pay based on the procedure code, uh, we pay 100% of the fee that's on the right hand side, but there's not a percentage as far as like um like you're saying 100, 80, 50 or 40, there's no percentages we pay just by that fee schedule.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty I will let my manager know thank you.
[AGENT][POSITIVE] You're welcome, [PII]. You're welcome. Anything else I can help you with? I'm sorry.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] OK, thank you for calling ATL. Have a good day bye.
[CUSTOMER][POSITIVE] All right you too bye bye.