AccountId: 011433970860
ContactId: 7340f431-765c-4f6f-bcc0-b5b04e3c3b2f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 335779 ms
Total Talk Time (AGENT): 114720 ms
Total Talk Time (CUSTOMER): 126383 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/7340f431-765c-4f6f-bcc0-b5b04e3c3b2f_20250110T17:40_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, this is [PII]. I'm calling from Doctor [PII] in office. One of our patients reached out letting us know that they now have, uh, coverage with APL, so we wanted to check the, uh, benefits and eligibility as well.
[AGENT][NEUTRAL] OK. And do you have a callback number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Policy number.
[CUSTOMER][NEUTRAL] Oh, I don't think that was provided for us, but they did, uh, give us the ID number.
[AGENT][NEUTRAL] What is the ID number?
[CUSTOMER][NEUTRAL] The D4 FFSB.
[AGENT][NEUTRAL] That's, that's the product type.
[AGENT][NEUTRAL] Do you have their social?
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] OK, I can look it up by that.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII] So
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And this is for her dental policy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what's her date of birth?
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you were just needing benefits for this policy.
[CUSTOMER][NEUTRAL] Yes, and then their maximum as well as a deductible left.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then uh we are an out of network.
[CUSTOMER][NEUTRAL] Uh, dental office, would you have, uh, a fee schedule that you'll be able to send us?
[AGENT][NEUTRAL] OK, I can help you with all that. The effective date is [PII]. This policy, we use Carrington's network. If you are not a provider with Carrington, we still accept assignment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um-hum.
[AGENT][NEUTRAL] It's not paid on a pay schedule. It's paid by usual and customary rate.
[CUSTOMER][NEUTRAL] Usual customary.
[AGENT][NEUTRAL] So if you're not a provider you would just charge your normal fees and we would pay the UCR.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] But I do have a fax back then I can fax you the benefits if you would like.
[CUSTOMER][POSITIVE] That would be great.
[AGENT][NEUTRAL] OK. What is your fax number?
[CUSTOMER][NEUTRAL] Uh, fax number [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'll fax that to you. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Yes, I wanted to check in on um.
[CUSTOMER][NEUTRAL] Let me see their inform and like in insurance information so uh we if if there's like a carrier name a group number, payer ID.
[AGENT][NEUTRAL] The group number is 70,030.
[CUSTOMER][NEUTRAL] 700
[AGENT][NEUTRAL] The group name.
[AGENT][POSITIVE] It's Creative circle.
[CUSTOMER][POSITIVE] Creative circle.
[AGENT][NEUTRAL] And the payer ID is 60801. That'll be on the fax as well.
[CUSTOMER][NEUTRAL] And then.
[CUSTOMER][NEUTRAL] 6.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's a payer ID you said.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And then was there a address for mailing claims and then.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 248,950.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. It'll be on the fax as well too.
[CUSTOMER][NEUTRAL] 7314.
[AGENT][NEUTRAL] 73 1 24.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And then uh would you uh happen to have a fax back number as well?
[AGENT][NEUTRAL] Hold on just a second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much for your help, [PII]. Would I have, uh, would you happen to have a reference number as well?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] OK, and uh today's date.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, thank you so much for your help, [PII] and then the fax is coming, OK.
[AGENT][NEUTRAL] Yes, ma'am. I'll fax it in just 1 2nd.
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] Thank you, [PII] for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.