AccountId: 011433970860
ContactId: c61de67b-5605-4386-ab3f-bca824f37e68
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 374459 ms
Total Talk Time (AGENT): 128266 ms
Total Talk Time (CUSTOMER): 101168 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/c61de67b-5605-4386-ab3f-bca824f37e68_20250214T15:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm calling from Dental Universe to verify the eligibility of a patient and a few other things.
[AGENT][NEUTRAL] OK, I can help you with eligibility. Um, can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Sure, my name is [PII].
[CUSTOMER][NEUTRAL] The callback number would be [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. What is the patient's name?
[CUSTOMER][NEUTRAL] Um, [PII]
[CUSTOMER][NEUTRAL] ON
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And what's the patient's date of birth?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] right.
[AGENT][NEUTRAL] OK, and what is our patient's policy number, please?
[CUSTOMER][NEUTRAL] The policy number is 70069.
[AGENT][NEUTRAL] So that's 70069?
[CUSTOMER][NEUTRAL] Yeah, 70069.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] OK, that is not a good policy number for us. Do you see another number?
[AGENT][NEUTRAL] Like a um group number.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] I see a certificate number.
[AGENT][NEUTRAL] OK, can you give me that number?
[CUSTOMER][NEUTRAL] It'll be 02.
[CUSTOMER][NEUTRAL] 4510.
[CUSTOMER][NEUTRAL] 54.
[AGENT][NEUTRAL] OK, and that's 02451054?
[CUSTOMER][NEUTRAL] They're doing the thing I.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, let me look it up with that number.
[CUSTOMER][NEUTRAL] Let me ask if he has.
[AGENT][NEUTRAL] OK, I've got him pulled up. I do see that [PII] does have an active policy. His effective date is [PII].
[AGENT][NEUTRAL] And give me your fax number I can send you a fax back with this complete benefit breakdown.
[CUSTOMER][NEUTRAL] OK, um, I just have a few, a few questions though. Is it in [PII]? does it cover [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Is it a sign out of of benefit out of network?
[AGENT][NEUTRAL] His benefits are through APL and Carrington.
[CUSTOMER][NEUTRAL] Uh and also it's a PPO.
[AGENT][NEUTRAL] Ma'am, I'm sorry, I didn't understand what you just said. I'm sorry, can you repeat what you just said? The phone broke up.
[CUSTOMER][NEUTRAL] Huh?
[CUSTOMER][NEUTRAL] Oh, is it a PPO insurance?
[AGENT][NEUTRAL] Yes, it's APL insurance and it's also through Carrington.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And it's um it's.
[CUSTOMER][NEUTRAL] Is that PPO?
[AGENT][NEUTRAL] No, it's paid by um UCR on the fee schedule.
[CUSTOMER][NEUTRAL] Wait, paid?
[CUSTOMER][NEUTRAL] By UCR?
[AGENT][POSITIVE] Yes, usual customary reasonable.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But it is [PII], right?
[AGENT][POSITIVE] Yes, he can use it in [PII].
[CUSTOMER][NEUTRAL] OK and.
[CUSTOMER][NEUTRAL] I just wanted to know the assignment of benefit out of network.
[AGENT][POSITIVE] OK, that's on the fee schedule that I can email to you. It'll have all of his benefits and it'll also have it broke down by our procedure code for you too.
[CUSTOMER][NEUTRAL] OK, do you mind faxing it over?
[AGENT][POSITIVE] No, I don't mind at all. I'll help you tremendously. Uh, what is your fax number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, Miss [PII]. I'm gonna get that faxed together for you. I'll be back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi [PII], this is [PII]. I've got that fax on its way to you now and just know that if the code is not on the fax back then it's not a covered procedure.
[CUSTOMER][NEUTRAL] It isn't the procedure code is not in the fax.
[CUSTOMER][NEUTRAL] It's not a covered procedure, OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome you have a blessed day and thanks for calling.
[CUSTOMER][POSITIVE] OK you too bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEGATIVE] You are on hold