AccountId: 011433970860
ContactId: 0281def9-7470-44d7-9049-bf13d79f210f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 302269 ms
Total Talk Time (AGENT): 127966 ms
Total Talk Time (CUSTOMER): 128961 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/0281def9-7470-44d7-9049-bf13d79f210f_20250116T13:39_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling ABL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling from a provider's office, Doctor [PII]'s office, calling to verify eligibility, uh, on a patient.
[AGENT][POSITIVE] It would be my pleasure to assist you with that eligibility. Do you mind repeating your name?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] Thank you, [PII]. And what is a good callback number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEGATIVE] Oh sorry.
[CUSTOMER][NEUTRAL] So the policy number is 02544418.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is uh [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, thank you. Is this for dental eligibility?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] All right, I can help you with that. If [PII], I am showing that [PII]'s policy is active. Effective date is [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. And then um.
[CUSTOMER][NEUTRAL] Is this uh her primary plan or is this considered her secondary?
[AGENT][NEUTRAL] For dental?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This is a limited dental plan.
[AGENT][NEUTRAL] And it is through her employer.
[AGENT][NEUTRAL] I don't have information of other dental coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I can fax you a breakdown if you'd like.
[CUSTOMER][NEUTRAL] So then, um, I mean.
[CUSTOMER][NEUTRAL] No, that's fine, but um are you able to see if we are in network with the patient's plan?
[AGENT][NEUTRAL] So with this policy, it does participate in the Carrington PPO network, but network participation is not required for benefits.
[CUSTOMER][NEUTRAL] OK, all right, um.
[CUSTOMER][NEUTRAL] And so then, um.
[CUSTOMER][NEUTRAL] So then on your system, you don't show that she has a secondary insurance, correct?
[AGENT][NEUTRAL] I do not. That is correct.
[CUSTOMER][NEUTRAL] OK. All right, so then, um, well, she does have another insurance through Blue Cross Blue Shield, which is, uh, it's not through her employer, it's, uh, an individual plan that she gets on her own.
[CUSTOMER][NEUTRAL] So, would that be considered
[CUSTOMER][NEUTRAL] Her secondary and you will be the primary or how would that work, do you know?
[AGENT][NEUTRAL] Yes, ma'am. I would assume that would be her secondary.
[CUSTOMER][NEUTRAL] So, APL will be the secondary insurance.
[AGENT][NEUTRAL] No, the Blue Cross would be secondary.
[CUSTOMER][NEUTRAL] Blue Cross Blue Shield. OK. All right. OK, so then, um,
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's all I needed to know then. Um, can I just get your name and a reference number for the call, please?
[AGENT][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] And [PII], it was a pleasure to assist you with that eligibility. Anything else I can help you with today? Did you want that that breakdown?
[CUSTOMER][NEUTRAL] Uh, sure, you can fax it to me.
[AGENT][POSITIVE] Sure, I'll be happy to. And [PII], what is the fax number, please?
[CUSTOMER][NEUTRAL] Um, the fax number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Just to verify that fax number, I am sending this to [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct, yes.
[AGENT][NEUTRAL] All right, [PII], now you're gonna get the calendar year max, deductibles, frequencies, limitations, and the procedures listed that are covered that will all be on the breakdown as well as our mailing address, payer ID and fax number. And just so you know, this policy does not cover major procedures, only preventive and basic.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, well then, um, thank you very much for your help and can I just get a reference number for the call?
[AGENT][NEUTRAL] [PII] reference number is my name and today's date. I spell my name [PII].
[CUSTOMER][POSITIVE] OK. All right, well then, [PII], thank you very much for your help and have a great day. Mm bye.
[AGENT][POSITIVE] I hope you have a great day as well, [PII]. Thank you for calling APL. Take care.
[CUSTOMER][POSITIVE] Thank you. You too, bye.
[AGENT][NEUTRAL] Bye-bye.