AccountId: 011433970860
ContactId: 96e35db4-d148-4bc3-b094-2a2e02d86c54
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 588830 ms
Total Talk Time (AGENT): 220270 ms
Total Talk Time (CUSTOMER): 170395 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/96e35db4-d148-4bc3-b094-2a2e02d86c54_20250513T14:07_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. This is [PII] calling from Sandy for Premier Dental, and I have dental insurance questions about a patient's policy.
[AGENT][NEUTRAL] OK, and I'm sorry, could you spell your name for me? I'm having trouble hearing you.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] That's [PII]
[AGENT][NEUTRAL] On show. OK, thank you and what is your callback number please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's a direct line. The number is [PII].
[AGENT][NEUTRAL] Thank you. And you said that you have questions on a member's dental policy, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Have you received, I can help you with this, [PII]. Have you received a fax back of the member's benefits?
[CUSTOMER][NEGATIVE] No, it didn't give me an option. It sent me straight to you guys.
[AGENT][POSITIVE] OK, yes ma'am. Well, we send fax back, so we'll have the member's benefits on there, so I'll be happy to send you that. What is the member's policy number?
[CUSTOMER][NEUTRAL] Uh, I have the social and it's [PII].
[CUSTOMER][NEUTRAL] 880818.
[AGENT][NEUTRAL] OK thank you give me a moment to locate the member's information please.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, and any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] My first name is [PII] Last name is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm. OK, thank you. And her date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. So yes ma'am, I do show that she is the subscriber on this dental policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is a good uh fax number that I can send her information to you at?
[CUSTOMER][NEUTRAL] Fax number is [PII].
[AGENT][NEUTRAL] Alright, one moment.
[AGENT][NEUTRAL] Will it need to be put to your attention, [PII], or is that not necessary?
[CUSTOMER][NEUTRAL] It's not necessary.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] So just one moment while that's loading.
[AGENT][NEUTRAL] And I'll go ahead and give you her her policy number will also be on the fax back, but it's 604188.
[CUSTOMER][NEUTRAL] 604-188. OK, thank you Mr. [PII].
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh, you're welcome. And I'm just gonna repeat your fax number to make sure I heard you correctly. [PII].
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, so I have just sent that to you now if you all end up filing a claim with us for hormone she once it has been processed, we do have a portal in which you should be able to check her claim status in and the website for our portal located at secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, thank you for that information, Ms. [PII]. Um, Miss [PII], I have a quick question.
[AGENT][NEUTRAL] Yes, you are certain.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Will it let me know if there if there's a time time the following deadline on the fax back?
[AGENT][NEUTRAL] I'm sorry, did you say a timely filing limit?
[CUSTOMER][NEUTRAL] Yes ma'am mhm.
[AGENT][NEGATIVE] There is no timely filing limits.
[AGENT][NEUTRAL] With APL.
[CUSTOMER][NEUTRAL] OK, um, what's the schedule or network is our office using through you guys?
[AGENT][NEGATIVE] There is no network.
[AGENT][NEUTRAL] And all this um, this plan has set benefits for each code that's covered and that information, the benefit amount is on the fax back.
[CUSTOMER][NEUTRAL] OK, so it, it wouldn't be Carrington option D what they provided the last time?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] That's
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK, um, will history be on the fax back?
[AGENT][NEUTRAL] No, ma'am. History is not on the facts back.
[CUSTOMER][NEUTRAL] OK. I just need to know if you have any history that would affect the frequency.
[AGENT][NEUTRAL] OK, what, um, OK, just one second.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what's, what is the first code you would like for me to check?
[CUSTOMER][NEUTRAL] Uh, 0330.
[AGENT][NEUTRAL] Uh, the last date of service was [PII].
[CUSTOMER][NEUTRAL] Uh, did she have a 02 10 after that because my records are showing 627-22.
[AGENT][NEUTRAL] 0210. Is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, there's no history on file for that.
[CUSTOMER][NEUTRAL] OK, well that just gave me more information. OK, does she have a uh 0274 on file? A bit wing?
[AGENT][NEUTRAL] 717 of 24.
[CUSTOMER][NEUTRAL] Mm, what about exams 0 140, 150, 120, 180?
[AGENT][NEUTRAL] Yeah, I have to check them one at a time. So, what was the first one?
[CUSTOMER][NEUTRAL] This exam code 0120.
[AGENT][NEUTRAL] Yes, ma'am, but I don't, I don't know, [PII], I don't know all of the, the dental codes because I work with a lot of different types of polic. OK. 0120 was also 717 of 24.
[CUSTOMER][NEUTRAL] It's, it's
[CUSTOMER][NEUTRAL] It's a 0120.
[CUSTOMER][NEUTRAL] OK, 11.
[AGENT][NEUTRAL] 7:17 of 2024.
[CUSTOMER][NEUTRAL] OK, alright, Ms. [PII], um, crowds are paid don't see the prep date.
[AGENT][NEUTRAL] Set
[CUSTOMER][NEUTRAL] Would that be on the facts?
[AGENT][NEUTRAL] It's paid on seat.
[CUSTOMER][NEUTRAL] See
[CUSTOMER][NEUTRAL] Last um either can the crown be done the same day as the build up?
[AGENT][NEGATIVE] It does not say that it does, it can't.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Can all 4 quarters be done the same day?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And is 9944 covered night guard?
[CUSTOMER][NEUTRAL] Oh, excuse
[AGENT][NEUTRAL] 9944. No, ma'am.
[CUSTOMER][NEUTRAL] Yes, ma'am. OK.
[CUSTOMER][NEUTRAL] Um, and there's no waiting period or missing tooth cloth, correct? I don't know if I asked that question.
[AGENT][NEUTRAL] Uh, there is, let's see.
[AGENT][NEUTRAL] Hold on just a second. It does have a missing tooth cloth that is on the backs back. And what was your other question?
[CUSTOMER][NEUTRAL] Uh, and I'm pretty sure there's no waiting period, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, alright, Ms. [PII], well that's all I need for, uh, Miss [PII]. Thank you for this information. um, thank you for sending the back.
[AGENT][POSITIVE] Well, you are very welcome.
[AGENT][NEUTRAL] Yes, sure sir.
[CUSTOMER][NEUTRAL] And I would just need a call reference number if you have one.
[AGENT][NEUTRAL] Sure, you would use my name along with today's date.
[CUSTOMER][POSITIVE] All right, thank you, Ms. [PII]. Have a wonderful Tuesday and a wonderful week.
[AGENT][POSITIVE] Well, oh, I hope you do too, [PII]. It was my pleasure speaking to you today and thank you again for calling ATL.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][POSITIVE] Hi, thank you. Bye bye.