AccountId: 011433970860
ContactId: 84a2a1d9-142c-414e-9802-14eeb7f3288b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 375899 ms
Total Talk Time (AGENT): 104658 ms
Total Talk Time (CUSTOMER): 258222 ms
Interruptions: 5
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/84a2a1d9-142c-414e-9802-14eeb7f3288b_20250128T17:29_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Calling ATL. my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Now that's one.
[CUSTOMER][NEUTRAL] [PII], my name is [PII]. I'm calling from Hollywood now.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, hello.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I have, I am a provider, I have a patient that I need to check eligibility and benefits for dental.
[AGENT][NEUTRAL] I'd be happy to assist with the eligibility. um, can you repeat your first name for me, please?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, your first name please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] And [PII], if I can get a good call back number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] The policy number. Give me one moment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] la la.
[CUSTOMER][NEUTRAL] Perreloro a bank. I have the police certification. That's OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 0255.
[CUSTOMER][NEUTRAL] 8116.
[CUSTOMER][NEUTRAL] It was.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII].
[CUSTOMER][NEUTRAL] Uh, the date of birth is [PII]. No. No, sweetie, sweetie, give me one moment.fing day, what else?
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII]. And were you needing a fax back breakdown of the benefits?
[AGENT][NEUTRAL] Effective date is [PII]. Were you needing a fax back breakdown of the benefits?
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] This is a PPO plan. And we are in network.
[AGENT][POSITIVE] Um, correct.
[AGENT][NEUTRAL] Um, are you in network with the Carrington PPO?
[CUSTOMER][NEUTRAL] Can you share me, please?
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] What is the fax number?
[CUSTOMER][NEUTRAL] 3 or 5.
[CUSTOMER][NEUTRAL] 402.
[CUSTOMER][NEUTRAL] 63
[CUSTOMER][NEUTRAL] 91.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah but right now that I got.
[CUSTOMER][NEUTRAL] Yeah Lizzy.
[AGENT][NEUTRAL] OK, with this policy, um, with this policy, there is no network.
[AGENT][NEUTRAL] So the patient can see any provider that they choose, um, and we go by UCR.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK. I UCR?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] No, it's, um, what is the maximum one is Simo.
[AGENT][NEUTRAL] 1500 per year.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Mm, sweetie, um, any waiting period missing too close.
[AGENT][NEUTRAL] Um, yes, their waiting period is one year.
[AGENT][NEUTRAL] So [PII], the waiting period will be over and yes, there is a missing tooth louse.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And for the waiting period for what procedure to apply?
[AGENT][NEUTRAL] Major.
[CUSTOMER][NEUTRAL] Major procedures, OK. So, what about, is the calendar year or fiscal year?
[AGENT][NEUTRAL] It's calendar.
[CUSTOMER][NEUTRAL] Maximum to use? Nothing, right?
[AGENT][NEUTRAL] I'm sorry, repeat that.
[CUSTOMER][NEUTRAL] Anything you? OK, uh, the doctor about 50, right?
[AGENT][NEGATIVE] No, they have not used anything.
[AGENT][NEUTRAL] The doctor what? I'm sorry?
[CUSTOMER][NEUTRAL] How much is the deductible?
[AGENT][NEUTRAL] You said how much? Oh, the deductible is $50.
[CUSTOMER][NEUTRAL] OK, uh, basic applied for basic and major, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. Preventive, basically a mayo, what is the percent?
[AGENT][NEUTRAL] Preventative is 100%, basic is 80, major is 40.
[CUSTOMER][NEUTRAL] And the other and perio, what is the percent?
[AGENT][NEUTRAL] That's considered um 40 major, so that's 40.
[CUSTOMER][NEUTRAL] So, Endo is mayor, or so is mayor, and Ped mayor.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] The 4341 can perform Sunday?
[AGENT][NEUTRAL] Um, coding is not given verbally. Um, you'll have to get that from the fax back, and you should receive that within 5 minutes.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK, let me, give me the credit ID and the address that I need to um.
[CUSTOMER][NEUTRAL] Submit the claim, please.
[AGENT][NEUTRAL] That's on the fax back as well, but the payer ID is 60801.
[CUSTOMER][POSITIVE] Perfect, my love.
[CUSTOMER][NEUTRAL] 60801, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK, I'm waiting for the fact. Thank you.
[AGENT][NEUTRAL] Was there anything else I could