AccountId: 011433970860
ContactId: def14d50-7ff5-4bf3-b8d3-0eb5eba7f1ec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 502450 ms
Total Talk Time (AGENT): 226382 ms
Total Talk Time (CUSTOMER): 174731 ms
Interruptions: 5
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/def14d50-7ff5-4bf3-b8d3-0eb5eba7f1ec_20250530T22:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. I was calling to find out if I was able to get a list of in-network uh dental offices.
[AGENT][NEUTRAL] OK, um, I think I spoke to you earlier. Were you looking for a birthday? OK, OK.
[CUSTOMER][POSITIVE] Yeah, you did, right, I was.
[AGENT][NEUTRAL] Let, let me go ahead and pull it up real quick.
[CUSTOMER][NEUTRAL] For diamond making. OK.
[AGENT][NEUTRAL] All right, and what is that date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me see here.
[AGENT][NEUTRAL] OK, so this dental plan isn't a network plan. It goes by UCR.
[AGENT][NEUTRAL] Uh, based off of the cer based off of the service region, um, it'll go off of the UCR. I can't remember what the.
[CUSTOMER][NEUTRAL] What does that mean?
[AGENT][NEUTRAL] Website is let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, you'll go through um
[CUSTOMER][NEUTRAL] So basically he can go through, he can go to any one.
[AGENT][NEUTRAL] Yes, he can go to any of them. Um, and if you'd like, I can give you a fax back of everything that he has covered. Let me find it real quick.
[CUSTOMER][NEUTRAL] I'm sorry, I was putting on my headphones. You said like you can do what?
[AGENT][NEUTRAL] Uh, if you'd like, I can give you a fax back that has everything that um is allotted on his policy.
[CUSTOMER][POSITIVE] Oh cool OK.
[AGENT][NEUTRAL] OK, um, do you have a good fax number?
[CUSTOMER][NEUTRAL] I do, it's 830.
[CUSTOMER][NEUTRAL] 469.
[CUSTOMER][NEUTRAL] 313 5.
[AGENT][NEUTRAL] OK. Yeah, and um it'll go off of UCR so it's got some preventative FMX basic and basic restorative. Um and it looks like there's a few major expenses and oral surgery expenses that they're allowed as well, and it has um our payer ID and where you can send the claim to as well on the fax back that I'm going to give you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, right, and let's wait just a moment while I send that, um, just to make sure that it went through. Give me just a moment while I fill it out.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you said so it's
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and it's a basic so he can go and get something as basic as a cleaning.
[AGENT][NEUTRAL] Yes, cleanings are allotted once every 6 months.
[CUSTOMER][NEUTRAL] And it's
[CUSTOMER][NEUTRAL] And does he pay anything out of pocket?
[AGENT][NEUTRAL] Uh, we don't do patient responsibility. It looks like.
[AGENT][NEUTRAL] Preventative expenses such as cleanings are 100% paid.
[AGENT][NEUTRAL] Um, again, that's just based off of the UCR, so it's 100% of the UCR, so it's what's in their service region.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] And let me see, um.
[CUSTOMER][NEUTRAL] And will the paperwork say what's in his service.
[AGENT][NEUTRAL] No, you will go to a site, um,
[AGENT][NEUTRAL] And are you you're a dental office, correct?
[CUSTOMER][NEUTRAL] No, uh, urgent care.
[AGENT][NEUTRAL] Oh, an urgent care? OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, um, most dental offices, um, I don't think it's super common, but they do know where to find the UCR. It's usually on, um, a site where you'll put in the, the service zip code, and there's certain amounts that are allotted, uh, so we can't give just basic amounts it goes based off of a percentage, right, um, and let me see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And um most, most dental offices, there's, there's someone who will know where to find that. Um, I can look for it.
[AGENT][NEUTRAL] I've, I've seen it a couple times. I just haven't done it enough to have it off the top of my head.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] Yeah, yeah, but, um.
[AGENT][NEUTRAL] There's a site that you go to, you type in the zip code of the dental office, and then it pays that amount.
[CUSTOMER][POSITIVE] Oh cool, OK.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] And let me
[AGENT][NEUTRAL] Oops.
[AGENT][NEUTRAL] I just want to make sure that the fax goes through.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And um what's your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] [PII], mhm.
[CUSTOMER][NEUTRAL] And I have his permission to call on his behalf.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] That.
[AGENT][NEUTRAL] Alright, I just sent that fax back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so that will the UCR um so that's the site and you said it'll give me when I look up.
[CUSTOMER][NEUTRAL] So it'll give me the site to be able to look up the zip code to get a certain amount.
[CUSTOMER][NEUTRAL] That's allotted. It'll give me a like a list uh or no.
[AGENT][NEUTRAL] Whoever works on the claims at the dental office should be able to do that, um.
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK, cool. I get it. OK. OK.
[AGENT][POSITIVE] Yeah, yeah, they'll be able to do it. Mhm.
[CUSTOMER][NEUTRAL] They'll be able to do OK so if they're not there they're probably.
[AGENT][NEUTRAL] And typically before they go they will verify um before they sit down to.
[AGENT][NEUTRAL] But yeah, um, we don't do patient responsibility we don't determine that that's up to the providers uh we just show the benefits that they have and what they, what they're allotted.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] Oh, OK. Oh, you do show that.
[CUSTOMER][NEUTRAL] And you can get that through going to that site or the oh you said the dental office to go to that site.
[AGENT][NEUTRAL] The general office should know where that site is. Mhm.
[CUSTOMER][NEUTRAL] Right, OK, but, OK, OK. OK.
[CUSTOMER][NEUTRAL] And it was said, Did you get a confirmation yet?
[AGENT][NEUTRAL] All right. And is there, is there anything else I can help you with?
[AGENT][NEUTRAL] Um, I haven't yet.
[CUSTOMER][NEUTRAL] No, I'm just waiting to see if they can, it hasn't come through yet.
[CUSTOMER][NEUTRAL] I want to know that you get a uh.
[CUSTOMER][NEUTRAL] A confirmation.
[AGENT][NEUTRAL] No, I just sent it. Typically, I get one through email.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me refresh and see mhm.
[CUSTOMER][NEUTRAL] Oh, you will? OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Is your office open on Saturdays just in case it doesn't come through?
[CUSTOMER][NEUTRAL] Cause we close at [PII] and I know you close at [PII].
[AGENT][NEUTRAL] Um, no, ma'am, we're not open on Saturdays.
[CUSTOMER][NEUTRAL] You're not, OK.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] You'll have to call back Monday.
[CUSTOMER][NEUTRAL] Is there any way for it.
[CUSTOMER][NEUTRAL] Oh, OK, uh oh, I'm getting something. Let me see.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Uh, American Fidelity.
[AGENT][NEUTRAL] American Public Life, American Fidelity, yes, ma'am.
[CUSTOMER][NEUTRAL] From [PII].
[CUSTOMER][NEUTRAL] OK, and it's more so how many pages is it?
[AGENT][NEUTRAL] Uh, I believe 2.
[CUSTOMER][POSITIVE] Oh, OK. I only got one coming through the front page. I only got to cover the letter. OK, so it's probably coming through. Thank you so much.
[AGENT][POSITIVE] Great, um, if there's nothing else, thank you for calling APL and I hope you have a great day.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.