AccountId: 011433970860
ContactId: 78100fbb-ac89-4d19-8962-40e4baf87ba0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 170240 ms
Total Talk Time (AGENT): 95529 ms
Total Talk Time (CUSTOMER): 55428 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/78100fbb-ac89-4d19-8962-40e4baf87ba0_20250108T21:10_UTC.wav
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[AGENT][NEUTRAL] For contacting UPO, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, I was calling um to see if we were in network with the insurance.
[AGENT][NEUTRAL] I can certainly look that up with whom am I speaking please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], thank you. What's that policy number that we're looking at today?
[CUSTOMER][NEUTRAL] It's 02567383.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][POSITIVE] I appreciate that. [PII], if I could just have a callback number, please, in the event that we're disconnected.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. Um, first of all, this policy went into effect on [PII] and it is active now.
[AGENT][NEUTRAL] Um, these particular dental policies, uh, pay, um, a percentage of or follow the, um, uh, fee schedule of Carrington PPO, the Carrington PTO fee schedule. They pay a percentage of that. Um, they have $500 for calendar year as the maximum, that's just a verification benefit's not a guarantee of payment, but there is no network, um.
[AGENT][NEUTRAL] So the, the insured can go to any uh provider that they want to. That's the, we use the Carrington PPOP schedule. uh but you don't need to be in uh network with Carrington uh for that to, uh, um.
[AGENT][NEUTRAL] To pay out. It's just that it only covers very basic dentistry such as um preventative, basic, and basic restorative only.
[CUSTOMER][NEUTRAL] OK, so we use your fees, not the usual and customary fees since we're not in.
[AGENT][POSITIVE] That's correct. Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, um, I don't think.
[CUSTOMER][NEUTRAL] Is there a way I can get a fax back?
[AGENT][NEUTRAL] Yes, of course. Um, what is your fax number, please?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] I can have that for you in just a moment. Is there anything else at all that I can help with?
[CUSTOMER][NEUTRAL] No, that's OK.
[AGENT][NEUTRAL] OK, well, I'll have this for you in just a second. Um, if you do have any questions, my name is [PII], um, but, uh, that's, I'll just have that for you and you can just uh look it over and see if you have anything else to ask.
[CUSTOMER][NEUTRAL] OK, and it's so you have your own fees so it's not like under emeritus or anything like that it's just your own fees.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Well, no, it's, it's, we follow the Carrington PPO fee schedule, um, and that, that is what we would use, we use a percentage of that.
[CUSTOMER][POSITIVE] OK, OK, alright, OK hon, all right, thank you.
[AGENT][NEUTRAL] OK, well thank you for contacting AP have a.