AccountId: 011433970860
ContactId: f5c58fd0-b1a7-4fbc-9199-83eccfc9a1bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 392570 ms
Total Talk Time (AGENT): 164231 ms
Total Talk Time (CUSTOMER): 111808 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/f5c58fd0-b1a7-4fbc-9199-83eccfc9a1bc_20250310T17:36_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. I help you?
[CUSTOMER][NEUTRAL] Hello. How are you?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] I'm good, thanks for asking. I was just wanting to confirm if we were in network with um y'all's insurance.
[AGENT][NEUTRAL] OK, I can help you. What's your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], what's the policy number?
[CUSTOMER][NEUTRAL] It is 01638292.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] option 2.
[AGENT][NEUTRAL] Option 2, thank you one moment.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you for that information.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you're wanting to know.
[AGENT][NEUTRAL] Either who the PPO network of contracted providers are or if you guys are contracted with the network, right?
[CUSTOMER][NEUTRAL] Yes ma'am, at for network.
[AGENT][NEUTRAL] OK, so there is no network of providers for this particular plan, it's uh patients provider of choice.
[CUSTOMER][NEUTRAL] OK, so are they assigned to an office?
[AGENT][NEUTRAL] No, they're not they can go to whomever they choose.
[CUSTOMER][NEUTRAL] So they can use their insurance here.
[AGENT][NEUTRAL] Yes, they can go they can choose a provider of their choice, any dental provider of their choice, because there is no network.
[AGENT][NEUTRAL] So yes, they can be seen by your office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK and then what's the group name and group number?
[AGENT][NEUTRAL] The group number is 14564 Universal Trucking.
[AGENT][NEUTRAL] And I believe that information is on their ID card as well.
[CUSTOMER][NEUTRAL] I didn't have the ID so I have to uh.
[AGENT][NEUTRAL] I figured you didn't, yeah, yeah, just letting you know if you wanted to make a copy of it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And then let me see it's American.
[AGENT][NEUTRAL] Public life.
[CUSTOMER][NEUTRAL] OK, let me see here.
[CUSTOMER][NEUTRAL] It's our first time seeing this insurance, so we're trying to get all the information. Let me see here.
[CUSTOMER][NEUTRAL] Let me try this.
[CUSTOMER][NEUTRAL] And then what's the claims address?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] 248,950.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 73 1 24.
[AGENT][NEUTRAL] 8950.
[CUSTOMER][NEUTRAL] You said 71234?
[AGENT][NEUTRAL] 73124.
[CUSTOMER][NEUTRAL] Let me see here.
[CUSTOMER][NEUTRAL] Do you give a full benefit breakdown or do y'all just send the fax?
[AGENT][NEUTRAL] Um, I can give you that over the phone and yes we can send it via fax as well.
[CUSTOMER][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does the fax have all the limitations, frequencies, and percentages?
[AGENT][NEUTRAL] It
[AGENT][POSITIVE] It does. It's about 89 pages long, including the cover, so it'll provide you with the calendar year maximum, the calendar year deductible, the category of expense, which is preventive basic and major, uh, the percentage of covered expenses, which is 100%, 80 and 40, 100 pre preventative, 80 basic, 40 major, um, they've exceeded the 12 month waiting period for major. It'll give you the frequencies, the common limitations and exclusions.
[AGENT][NEUTRAL] Um, the payer ID number, fax number, and claims mailing address and then it'll list each procedure code that's covered under the policy and any limitations, it'll address it per procedure code on the schedule of benefits pretty very, very detailed.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Perfect. Would you mind if I get a fax of that because I think I have to register y'all's claims address. I don't think we've ever used one of y'all's insurances before.
[AGENT][NEUTRAL] OK, sure, what's your fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, give me one second. Let me prepare this document real quick.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] And Eldred is the patient, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Your name is it [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right, so I just sent the fax over to you.
[AGENT][NEUTRAL] And it doesn't take it long. I'll get a confirmation once it's received if if it was abandoned due to busy or no answer or whatever other reason, I will call you back um to see if you would like it, yeah, to, to verify.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Alrighty, it may take a minute because I don't see it on our end. No ma'am, that was all.
[AGENT][NEUTRAL] Anything else?
[AGENT][NEUTRAL] It will cause it's
[AGENT][NEUTRAL] It's about 8 pages and it'll try to, it'll try to send it at least 3 to 5 times.
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] All right, if no other questions, [PII], thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.