AccountId: 011433970860
ContactId: f169cc28-bb5f-4555-aa78-2be245ef4683
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 593900 ms
Total Talk Time (AGENT): 188553 ms
Total Talk Time (CUSTOMER): 156149 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/f169cc28-bb5f-4555-aa78-2be245ef4683_20250414T18:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, good morning. Uh, sorry, good afternoon. This is [PII] from the dental office. Greatmouth Ber Center. Sorry, can I have your name again?
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][POSITIVE] Perfect. Thank you so much, [PII].
[AGENT][NEUTRAL] And what is
[AGENT][NEUTRAL] Thank you, [PII]. And what's the name of the dental office you're calling from, please?
[CUSTOMER][NEUTRAL] Oh, greatmouth Buford Center.
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] And then may I also get your callback number just in case the call gets disconnected, I'll be able to call you right back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm, sure. That's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] How can I help you today?
[CUSTOMER][NEUTRAL] Yes, I am calling to check the patient's dental coverage if there is.
[AGENT][NEUTRAL] OK, I can check um eligibility for you. May you please give me the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Sure. The patient's name is [PII].
[CUSTOMER][NEUTRAL] The first name is [PII] and the last name is [PII]. That's [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And then what is the member's uh ID?
[CUSTOMER][NEUTRAL] Number ID is 02536633.
[AGENT][NEUTRAL] OK, let me pull that up real quick for us.
[AGENT][NEUTRAL] OK, I do show that one flat does have an active policy. The effective date of the policy is [PII], and if you give me your fax number, I can send a fax back with the benefit breakdown and fee schedule for you.
[CUSTOMER][NEUTRAL] OK, perfect. So, fax number is 470508.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold [PII] while I get that fax ready for you and I will be right back.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, [PII]. I have that fax on its way to you now.
[CUSTOMER][NEUTRAL] OK, perfect. Thank you so much, [PII]. And by the way, while I have you on the line, can you please confirm the patient's uh group number, claims, mailing address, and payer ID?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, the group number is 70055.
[AGENT][NEUTRAL] That's TCR staffing, I'm sorry, TRC staffing.
[AGENT][NEUTRAL] Uh, the payer ID number is 60801.
[CUSTOMER][POSITIVE] All right. Thank you. And how about
[AGENT][NEUTRAL] And you asked one more question. What was?
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes. Just to confirm, the group number is 7,55, right?
[AGENT][NEUTRAL] 705570055.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK. And the payer ID is 60801.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK. Yes. And how about the claims mailing address?
[AGENT][NEUTRAL] That would be [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] That's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK. Thank you. Is there any termination date on the patient's policy?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] No, the policy is paid to and active.
[CUSTOMER][NEUTRAL] OK. How about the C schedule and if the office is in-network?
[AGENT][NEUTRAL] Uh, they can use anybody they want to use and the fee schedules on your fax back.
[CUSTOMER][NEUTRAL] Oh, OK. But is the office in network or out of network?
[AGENT][NEUTRAL] It's they can use any office they want to um we pay by UCR.
[CUSTOMER][NEUTRAL] Oh, so UCR I just understand.
[CUSTOMER][NEUTRAL] But can we use Connection Dental since we are a network with Connection Dental?
[AGENT][NEUTRAL] They're associated with Carrington, but they do not have to utilize a provider within the Carrington network.
[CUSTOMER][NEUTRAL] Oh, OK. So, technically, the fee schedule is UCR.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] And um is the office in-network or out of network?
[AGENT][NEUTRAL] They don't have a network they can use anybody they want to.
[CUSTOMER][NEUTRAL] Mm, OK, got it. This is new to me. I'm sorry. And what would be the patient's annual max?
[AGENT][NEUTRAL] That's on the fee schedule. Um, that annual maximum is $500.
[AGENT][NEUTRAL] And this is just to verify benefits. It's not a guarantee of payment.
[CUSTOMER][NEUTRAL] 0, 2500.
[CUSTOMER][NEUTRAL] I see. OK. And the remaining, is it still 500?
[AGENT][NEUTRAL] Let me check their history real quick to see.
[AGENT][NEUTRAL] If they've used anything.
[AGENT][NEGATIVE] Nothing has been used for the year of [PII].
[CUSTOMER][NEUTRAL] Got it. Thank you. Any individual and family deductible?
[AGENT][NEUTRAL] $50. That's also on your fee schedule.
[AGENT][NEUTRAL] On your benefits
[CUSTOMER][NEUTRAL] I see. OK. Um, is there a waiting period that I'm missing two slots?
[AGENT][NEUTRAL] No, there's no waiting period and there is a missing tooth clause.
[AGENT][NEUTRAL] That is also on your benefits.
[CUSTOMER][NEUTRAL] Mm, OK, got it. Uh, while I have you on the line, may I know the date for the missing tooth clause?
[AGENT][NEUTRAL] The date for what was it, please?
[CUSTOMER][NEUTRAL] For the missing tooth cloth.
[AGENT][NEUTRAL] There's no date.
[CUSTOMER][NEUTRAL] What is the period?
[AGENT][NEUTRAL] It just says this policy does have a missing tooth clause.
[CUSTOMER][NEUTRAL] Oh, OK. So until the plan is effective.
[AGENT][NEUTRAL] There's no date.
[AGENT][NEUTRAL] Yes, from the effective date of the plan.
[CUSTOMER][NEUTRAL] I got it. Uh, may I please have the reference number for this call?
[AGENT][NEUTRAL] Yes, you can use my name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK. Perfect. Thank you so much, sorry, for your assistance today.
[AGENT][POSITIVE] You're very welcome. Is there anything else, [PII], I can help you with before we go?
[CUSTOMER][POSITIVE] None for now. Thank you.
[AGENT][POSITIVE] Alright, well, you have a wonderful day and thank you for calling APL.
[CUSTOMER][NEUTRAL] Likewise. Bye-bye.
[AGENT][NEUTRAL] Mm bye-bye.