AccountId: 011433970860
ContactId: 5c8dbcb4-c163-46de-b336-edb78408605a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228190 ms
Total Talk Time (AGENT): 103992 ms
Total Talk Time (CUSTOMER): 93657 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/5c8dbcb4-c163-46de-b336-edb78408605a_20250429T15:24_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name's [PII]. I'm calling from a dental office trying to find out if I'm in network with this plan at all.
[CUSTOMER][NEUTRAL] For a particular patient.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, I can definitely help you with the network. And [PII], may I have a good contact number in case we're disconnected and the member's policy number?
[CUSTOMER][NEUTRAL] My phone number is [PII].
[CUSTOMER][NEUTRAL] And the patient's member ID is, can I find it? 02539196.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] I have [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active, it's been effective since [PII].
[AGENT][NEUTRAL] And now the policy is on the Carrington PPO network. However, if you are not a Carrington provider, the benefits are still the same. Now for the list of in-network providers, I have the phone number for Carrington. We just don't have access to the list because it's a different company.
[CUSTOMER][NEUTRAL] OK, I know that we're like we're associated with Carrington's fee schedule so I should be in network so if I'm in network with Carrington, I'm in network with this plan.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] To my understanding, yes, because it's the Carrington PPO network.
[CUSTOMER][NEUTRAL] OK, but it is PPO. OK, um, does the patient have any um history on file?
[AGENT][NEUTRAL] Let me see, hold on one moment.
[AGENT][NEUTRAL] Um, not yet. We haven't processed any claims for the patient.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And did you need a copy of the fax back?
[CUSTOMER][NEUTRAL] Are you able.
[AGENT][NEUTRAL] Is that what you were about to ask?
[CUSTOMER][POSITIVE] Yeah, that'd be awesome.
[AGENT][NEUTRAL] And what's a good fax number for you?
[CUSTOMER][POSITIVE] I'm so sorry, say that again, my dear.
[AGENT][NEUTRAL] Um, what's a good fax number for you?
[CUSTOMER][NEUTRAL] Oh, fax number [PII].
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] All right, and should I put attention [PII]?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] And I was
[CUSTOMER][NEUTRAL] And that includes sorry go ahead.
[AGENT][NEUTRAL] Oh, sorry.
[AGENT][NEUTRAL] No, I just want to make sure I had it right. Um, it was 215739-7239.
[CUSTOMER][NEUTRAL] Yes ma'am, and then if you could just confirm your payer ID I think that's the only thing I need.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][POSITIVE] Perfect, um, and that fact that will include deductibles maximum and like basic breakdown and stuff, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Cool.
[AGENT][NEUTRAL] And then there's also uh the
[CUSTOMER][NEUTRAL] All right, that's all I really need. Mhm.
[AGENT][NEUTRAL] The list of covered codes that the code you're looking for isn't on the list, then it wouldn't be covered by the policy.
[CUSTOMER][POSITIVE] Perfect. OK.
[AGENT][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] And then can I just have a reference number?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date, which is [PII], first initial to my last name is [PII], and then today's date.
[CUSTOMER][POSITIVE] All right my dear, thank you so much for your help appreciate it.
[AGENT][NEUTRAL] You're welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] Alright, thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.