AccountId: 011433970860
ContactId: 5204c7ba-4066-4387-8228-d94f86c42832
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 276750 ms
Total Talk Time (AGENT): 132802 ms
Total Talk Time (CUSTOMER): 105075 ms
Interruptions: 2
Overall Sentiment: AGENT=1.6, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/5204c7ba-4066-4387-8228-d94f86c42832_20250505T19:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I have a patient in the office named [PII], and I was just calling to see if we're in network with her insurance.
[AGENT][NEUTRAL] OK, yeah, I can check that work for you. um, what was your name please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm so sorry, could you uh spell that again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and then can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Her policy number is 02556897.
[AGENT][NEUTRAL] OK, and um let's see, you did say this was [PII]. Do you have her date of birth?
[CUSTOMER][NEUTRAL] Her date of birth is [PII].
[AGENT][NEUTRAL] Perfect thank you so much for verifying that. OK, so this policy is active. Effective date was [PII]. Uh, this policy participates in the Carrington PPO network. Uh, however, utilization of a provider within that network is not required, and if you would like, I can send you a fax back that shows all of the covered procedures and benefit information.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yeah, and it's not a fee schedule, right?
[AGENT][NEUTRAL] Correct, um, it's uh the Carrington PPO.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEGATIVE] OK, because we fall under and does and when I group it do our group because we under curing do our group it under the curing network.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Not UCR.
[AGENT][POSITIVE] I'm sorry
[CUSTOMER][NEUTRAL] I group it under the current network.
[AGENT][NEUTRAL] Under it's yes it participates in the Carrington PPO.
[CUSTOMER][NEUTRAL] OK, and then, OK, and we are in work. I gave you the tax ID number, right?
[AGENT][NEUTRAL] Um, you did not, however, I don't have a way of seeing that. Um, I would have to transfer you to Carrington for that.
[AGENT][NEUTRAL] Did you want me to give you their information?
[CUSTOMER][NEUTRAL] OK, but you said we do take it.
[CUSTOMER][NEUTRAL] No, that's fine, but you said we are in network with it.
[AGENT][NEUTRAL] Um, I, I don't know if you are in network. I have no way of seeing that. Um, I just know this plan participates in that network, but the utilization of a provider within that network is not required, so you could still send that information.
[CUSTOMER][NEUTRAL] OK, alright.
[AGENT][NEUTRAL] Yes, did you need anything, uh, any other questions for me?
[CUSTOMER][NEUTRAL] Alright, that's fine, um.
[CUSTOMER][NEUTRAL] Um, no, um, can you fax over the benefits?
[AGENT][NEUTRAL] Of course, what was that fax number for you?
[CUSTOMER][NEUTRAL] Um, [PII] um sticking out [PII].
[AGENT][NEUTRAL] OK, I'm going to read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] Yes ma'am, and then um what is the um what's the um payer ID for this?
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] That is 60801.
[CUSTOMER][NEUTRAL] And what's the mailing address?
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] And that is in
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Huh.
[CUSTOMER][NEUTRAL] And what's the group number?
[AGENT][NEUTRAL] Uh, one moment, let me get that.
[CUSTOMER][NEUTRAL] Is it 70054?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, what's your name?
[CUSTOMER][NEUTRAL] OK, I think I get it and what's her max?
[AGENT][NEUTRAL] Um, this one is uh $500 max, uh, per calendar year with a $50 deductible that does not apply to preventative expenses.
[CUSTOMER][NEUTRAL] OK, how much do you guys pay on preventative?
[AGENT][NEUTRAL] Preventative is at 100%.
[CUSTOMER][NEUTRAL] What about basic?
[AGENT][NEGATIVE] Basic is at 80% and this uh this plan does not have any major coverage it's just going to be preventative, basic and uh radiographs.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, what does, what's following the major like endo?
[AGENT][POSITIVE] Yes, that's correct. Uh, endo oral surgery, uh, periodontic. Yes.
[CUSTOMER][NEUTRAL] Crowns.
[CUSTOMER][NEUTRAL] OK, all that's on the major. OK, OK, can you fax me over the benefits? OK, thank you.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, absolutely. Thank you. Have a great rest of your day.
[CUSTOMER][NEUTRAL] Mhm bye bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Yes