AccountId: 011433970860
ContactId: 09e83b36-d119-491f-8c22-03e51a961b8e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 469540 ms
Total Talk Time (AGENT): 192332 ms
Total Talk Time (CUSTOMER): 137259 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/09e83b36-d119-491f-8c22-03e51a961b8e_20250225T14:47_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, um, I got transferred to this line, um, for one of our patients, um, benefits and eligibility.
[AGENT][NEUTRAL] OK, I can verify benefits and eligibility for you and your name is?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] Oh, OK, and what's that policy number, please?
[CUSTOMER][NEUTRAL] It is 492-847-22.
[AGENT][NEUTRAL] Uh, it's not one of our policy numbers. Is that the policy holder's social? No, it's too small. Um.
[CUSTOMER][NEUTRAL] Mm, no, this is the one that they gave me, the last representative gave me.
[AGENT][NEUTRAL] What is the patient's name?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Last name is [PII]
[AGENT][NEUTRAL] OK, thank you. And do you have the date of birth?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK, thank you, ma'am. And Ms. [PII], do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] called
[CUSTOMER][NEUTRAL] Yes, it'll be [PII].
[CUSTOMER][NEUTRAL] Um, OK, give me one second.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you. Give me one moment.
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] OK, um, when you're ready, I can give you their policy number with our company.
[CUSTOMER][NEUTRAL] OK, give me one second. I'm gonna pull up the.
[CUSTOMER][POSITIVE] OK, I'm ready for the number.
[AGENT][NEUTRAL] OK, it's 259-819-7.
[AGENT][NEUTRAL] Effective date is, I'm sorry, [PII] of this year, and I'm trying the policy is active and what benefits are needed for this patient?
[CUSTOMER][NEUTRAL] Um, I have some other questions. Um, can I get the group name?
[AGENT][NEUTRAL] Sure. Group name is.
[AGENT][NEUTRAL] OK. I'm gonna have to spell it. Um.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] A
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] [PII] Services LLC.
[CUSTOMER][NEUTRAL] [PII] is AA.
[AGENT][NEUTRAL] No, it's just a space and then A and then Tara.
[CUSTOMER][NEUTRAL] At the end
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then [PII]
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. Can I get the group number?
[AGENT][NEUTRAL] 700073.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Alright, and can I get the, is this Carrington still or what can you give me our seat schedule?
[AGENT][NEUTRAL] Is this for dental or is this for medical?
[CUSTOMER][NEUTRAL] Yes, for dental.
[AGENT][NEUTRAL] Oh, I apologize. Give me one moment. I gave you medical. I should have asked. Uh, when you're ready, I can give you that dental policy number.
[CUSTOMER][NEUTRAL] OK, I'm ready for the policy number.
[AGENT][NEUTRAL] OK, 259-819-9.
[AGENT][NEUTRAL] Same effective date, same group number and group name.
[AGENT][NEUTRAL] And we don't follow uh Carrington. They can go to Carrington provider if you need to verify if you're with Carrington, you will have to contact Carrington and I'll give you their phone number, but um this policy is a limited group dental plan that pays by UCR.
[CUSTOMER][NEUTRAL] OK, what is the name?
[AGENT][NEUTRAL] What's the name of the what company? APL?
[CUSTOMER][NEUTRAL] Of the, of the
[CUSTOMER][NEUTRAL] APL.
[CUSTOMER][NEUTRAL] Is, is it [PII]? Is that what it's called?
[AGENT][NEUTRAL] No, it's APL, American Public Life APL.
[CUSTOMER][NEUTRAL] My
[CUSTOMER][NEUTRAL] OK, I do have it here.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Can I get a PO box, please?
[AGENT][NEUTRAL] Uh yes, ma'am. PO [PII] 248,950.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. And does the patient have a deductible?
[AGENT][NEUTRAL] Uh, there is a $50 deductible that is applied to everything but preventative services.
[CUSTOMER][NEUTRAL] OK, does she have a maximum?
[AGENT][NEUTRAL] Uh yes, ma'am. Uh, not a guarantee of payment, just a verification of coverage. She has a benefit max of up to $500 for a calendar year.
[CUSTOMER][NEUTRAL] $500?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and can I just, I'm guessing she doesn't have any ortho coverage, right?
[AGENT][NEUTRAL] Correct, um, ortho or any other major services like crowns, bridges, partials, dentures, endo perio, and oral surgery is not covered. It polys only covers for preventative and basic.
[CUSTOMER][NEUTRAL] OK, and what are basic services that it does cover?
[AGENT][NEUTRAL] Uh, basic is at 80% of UCR.
[CUSTOMER][NEUTRAL] OK, and, um, is there's a fee schedule that's, there's a fee schedule for this correct?
[AGENT][NEUTRAL] No, ma'am. We don't pay by fee schedule. It pays by UCR.
[CUSTOMER][NEUTRAL] That they go through it.
[CUSTOMER][NEUTRAL] OK, I, I see. Give me one second. Let me just take a picture of that.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] OK, so there's nothing that you can fax to us with um any of this information correct?
[AGENT][NEUTRAL] I can send you a fax back. Um, what's your fax back, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK, um, it is going to be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, that's [PII], I'm sorry, [PII].
[CUSTOMER][NEGATIVE] Correct, and then, um, if you don't mind giving me that a policy number one more time because I can have exited out of that page.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, yes, ma'am. Uh, it's 259-819-99.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty, thank you so much. And do you know how long that the fax will take to get to our office?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Oh, so just give me a few moments. I say give it about 5 minutes.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] All right. And is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] That'll be it. Thank you so much.
[AGENT][POSITIVE] Uh, yes, ma'am. Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] OK