AccountId: 011433970860
ContactId: b9379790-715d-42e3-886b-ed3f08820823
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 232259 ms
Total Talk Time (AGENT): 111944 ms
Total Talk Time (CUSTOMER): 66083 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/b9379790-715d-42e3-886b-ed3f08820823_20250224T16:16_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, this is [PII] at Sky Family Dental, and I need to know if this patient's insurance have coordination of benefits.
[AGENT][NEUTRAL] Sure, I can check on that for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh yeah, [PII].
[AGENT][NEUTRAL] All right, thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes. It's gonna be um 651-860.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, and then, uh, what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Perfect. OK, thank you for verifying that [PII]. Let's see, so this policy is active. Effective date was [PII], and give me one moment, let me get that pulled up here.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If you'd like I can also send you a copy of the fax back that shows all covered procedures and benefit information.
[CUSTOMER][NEUTRAL] I have, I do have that.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All righty.
[AGENT][NEUTRAL] Just a moment.
[AGENT][NEUTRAL] OK and so you said that you were trying to check to see if it had um.
[AGENT][NEUTRAL] Uh, coordination of benefits.
[CUSTOMER][POSITIVE] Coordination of benefits, yes.
[AGENT][NEUTRAL] I
[AGENT][NEGATIVE] Do you not believe this one does, as this one just pays a set dollar amount per covered procedure.
[CUSTOMER][NEUTRAL] OK, so what do I need to do with that?
[AGENT][NEUTRAL] You just file those claims directly to us, the benefit amount that you see, oh sorry, go ahead.
[CUSTOMER][NEUTRAL] Right, but he has a prime, he has a primary insurance.
[AGENT][NEUTRAL] Oh, for dental?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] I believe this plan just pays that set amount regardless, um, but if you give me one moment, [PII], I'm gonna put you on a brief hold. I'll just get some clarification on that. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Ping
[CUSTOMER][NEUTRAL] This is [PII]. May I help you?
[AGENT][NEUTRAL] Hi this is [PII] over on the care team. How are you?
[CUSTOMER][NEUTRAL] I'm fine. How are you?
[AGENT][NEUTRAL] Doing alright thank you. I just had a question for you. I've not actually run across this. I have a provider calling to ask about um coordination of benefits. This is one of the uh select dental policies that just pays the set dollar amount uh per procedure, um.
[CUSTOMER][NEGATIVE] They do not coordinate benefits at all.
[AGENT][NEUTRAL] I didn't think so. It just pays that amount regardless, right?
[CUSTOMER][NEUTRAL] Right, no matter what other, the other insurance pays, it pays what's on that pay schedule.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] That is what I thought just wanted to make sure. I appreciate it. Thank you.
[CUSTOMER][POSITIVE] You're welcome. Bye-bye.
[AGENT][NEUTRAL] All right, bye bye.
[AGENT][NEUTRAL] OK, [PII], sorry about that wait are you still with me?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so yes, I was right. I just wanted to make sure. So yeah, there's no uh coordination or anything it just pays the set amount regardless of other coverage.
[CUSTOMER][NEUTRAL] And her date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All righty.
[AGENT][NEUTRAL] OK. Was there anything else I can help you with?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] No, so they just pay the set amount no matter the fee?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, that's all I needed.
[AGENT][POSITIVE] Alright, well thanks for calling AP. I hope you have a great rest of your day, uh huh.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.