AccountId: 011433970860
ContactId: c79991f9-0ecd-4a59-a531-2f6363a0263b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 307850 ms
Total Talk Time (AGENT): 126461 ms
Total Talk Time (CUSTOMER): 127955 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/c79991f9-0ecd-4a59-a531-2f6363a0263b_20250516T16:26_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, hi, I'm calling in I'm calling from Brighton Dental Orthodontics. My name is [PII] and I'm calling in regards to benefits for a patient.
[AGENT][NEUTRAL] OK, I can verify benefits for you. And you say your name is [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] And what is that policy number, please?
[CUSTOMER][NEUTRAL] That's going to be.
[CUSTOMER][NEUTRAL] Oh, hold on.
[CUSTOMER][NEUTRAL] 02623588.
[AGENT][POSITIVE] Thank you, ma'am. Give me one moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you, ma'am.
[AGENT][NEUTRAL] Let's see and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] [PII] date of birth is going to be [PII].
[AGENT][NEUTRAL] OK, I'm showing his effective date is [PII] and it is active, and you say you're needing benefits, correct?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Correct, yes. I'm also needing to know um what plan is this? I mean, I, I've never heard of this type of plan so I'm just a little confused.
[AGENT][NEUTRAL] I understand. Uh, well, the policy the patient has, whether it's a group dental plan.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Or a limited group dental plan covers from preventative and basic services.
[CUSTOMER][NEUTRAL] OK, what fee schedule will my provider be using?
[AGENT][NEUTRAL] Well, we don't, um, well, the policy is open, we don't have a contract with you unless you are with Carrington or have a contract with Carrington, then I guess you would go by.
[CUSTOMER][NEUTRAL] Yeah, we, we
[AGENT][NEUTRAL] Uh, the fee schedule y'all have, um.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] For Carrington?
[AGENT][NEUTRAL] With them. Yes, ma'am, but the policy just pays by UCR.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, I don't get it. So am I gonna use the UCR fee schedule or the Carrington?
[AGENT][NEUTRAL] Uh, you go by Carrington if you have a contract with them, yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We just pay by UCO.
[CUSTOMER][NEUTRAL] You wouldn't be able to tell me if my providers in network with [PII] and correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and then uh what is their annual maximum?
[AGENT][NEUTRAL] Alright one moment.
[CUSTOMER][NEUTRAL] 1.
[AGENT][NEUTRAL] OK one moment.
[AGENT][NEUTRAL] OK, uh, not a guarantee of payment, just a verification of coverage and show the patient has a benefit max up to $750 per calendar year.
[CUSTOMER][NEUTRAL] 750. OK, have they used any of their benefits?
[AGENT][NEUTRAL] Uh, no, ma'am. Uh, they haven't used any benefits or me deductible for this year.
[CUSTOMER][NEUTRAL] Would you be able to send what is the deductible? I'm sorry?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] What's the deductible?
[AGENT][NEGATIVE] They haven't met their deductible. It's $50 that is applied to everything but preventative services.
[CUSTOMER][NEUTRAL] How much is it?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it's but it's just preventative and basic, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, can you verify um.
[CUSTOMER][NEUTRAL] I'm sorry, can you verify if another patient is in um under the same policy as well?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. What's that policy number?
[CUSTOMER][NEUTRAL] It's the same one, but it's uh for patient [PII].
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] And what's the date of birth?
[CUSTOMER][NEUTRAL] I have um [PII].
[AGENT][NEUTRAL] I don't show that patient under the plan.
[CUSTOMER][NEUTRAL] OK, is it, you don't show the the um date of birth or or no patient with that name at all?
[AGENT][NEUTRAL] I don't show.
[AGENT][NEUTRAL] I don't show that patient under this plan.
[CUSTOMER][NEUTRAL] OK, OK, so just for guide. OK, I'll go ahead and uh get in contact with the patient, OK?
[AGENT][POSITIVE] OK, and it's, you're welcome. Thank you for calling ACL.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Oh, you were gonna fax it to me, right?
[AGENT][NEUTRAL] Well, you didn't ask, but I can send you a fax back. What's your fax number?
[CUSTOMER][NEUTRAL] Were you gonna fax it to me?
[CUSTOMER][NEUTRAL] I'm sorry, yes.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]:56.
[AGENT][NEUTRAL] OK, uh, that's [PII]6-465-1056.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, I will send that off to you in a few moments. Uh, is there anything else I can assist you with today, Ms. Annabelle?
[CUSTOMER][POSITIVE] That'll be all thank you.
[AGENT][POSITIVE] Alright, you're welcome. Thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Mhm bye bye.
[AGENT][NEUTRAL] Bye.