AccountId: 011433970860
ContactId: 523fccd2-5a6b-4d67-978b-455a92426bb8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 237479 ms
Total Talk Time (AGENT): 107287 ms
Total Talk Time (CUSTOMER): 73884 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/523fccd2-5a6b-4d67-978b-455a92426bb8_20250313T15:36_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, um, I was just trying to see if we are in network with this with y'all's insurance for this patient.
[AGENT][NEUTRAL] OK, I can verify that for you. And your name is?
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] And Ms. [PII], do you have that policy number?
[CUSTOMER][NEUTRAL] Um, yes, it's going to be 60801.
[AGENT][NEUTRAL] Uh, that sounds like a payer ID number. Uh, do you have a copy of the card in front of you?
[CUSTOMER][NEUTRAL] Uh, yeah, give me one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, the policy number is 02441264.
[AGENT][NEUTRAL] OK, thank you, ma'am. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] His name is [PII] and then the last name is [PII]
[AGENT][POSITIVE] OK, thank you so much. Uh, and this is for dental, correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. Well, with this policy, we don't have a network. Uh, what that means is our insurance can go to any dental provider and for any dental provider, we do take assignments.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the policy pays by UCR.
[CUSTOMER][NEUTRAL] B ECR, OK, so do you know if it's like a PPO or a DMO?
[AGENT][NEUTRAL] Uh, neither. It's just a limited group dental plan, but, um, if you like, I can send you a fax back.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, yes, please, do you mind sending me that?
[AGENT][NEUTRAL] OK, and what is your fax number?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, and that's [PII].
[CUSTOMER][NEUTRAL] Yes ma'am. And then um what did you say the type of insurance was?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's just a limited group dental plan. Uh, we don't have a network, so it's not a DMO or HMO or anything like that or PPO.
[CUSTOMER][NEUTRAL] OK and then um the thing that you're faxing over, does it go with the fee schedule or something?
[AGENT][POSITIVE] Well, it gives the UCR amount. As I said, the policy pays by usual customer and reasonable.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it'll have the percentage for preventive, basic and major as well as our mailing address, fax number and payer ID for claims.
[CUSTOMER][POSITIVE] OK, sounds good.
[AGENT][NEUTRAL] Oh, if it works.
[AGENT][NEUTRAL] OK, and is there anything else I can assist you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] Do you mind repeating that thing one more time about the fee schedule saying how you guys don't have that?
[AGENT][NEUTRAL] Well, it doesn't pay by fee schedule, it pays by UCR, um, usual customary reasonable for like preventive basic and major services that will be on the fax back.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, sounds good. um, that should all I, that should be all I needed thank you.
[AGENT][NEUTRAL] Uh, you're welcome. And I'll just let you know, also on the fax back, it does have uh frequencies as well.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Yes, ma'am. And is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um, that should be it.
[AGENT][POSITIVE] OK. Well, I thank you so much for calling APL and you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you so much you too bye bye.
[AGENT][NEUTRAL] Bye.