AccountId: 011433970860
ContactId: 15c2008c-7bfd-4635-bb49-02ebd02a45d2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 454899 ms
Total Talk Time (AGENT): 152302 ms
Total Talk Time (CUSTOMER): 145068 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/15c2008c-7bfd-4635-bb49-02ebd02a45d2_20250303T16:38_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] [PII], my name is [PII]. I'm calling from Aspen Dental. How are you?
[AGENT][POSITIVE] I'm doing well. How are you?
[CUSTOMER][POSITIVE] I'm doing good, thank you for asking.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I am, um, oh I'm sorry, I am needing to um verify dental benefits for a patient please.
[AGENT][POSITIVE] OK, well, I can definitely help you with the benefits and [PII], may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] It's [PII] option 2.
[AGENT][POSITIVE] Thank you for that. And the policy number?
[CUSTOMER][NEUTRAL] So I'm sorry, what was that hon?
[AGENT][NEUTRAL] the, um, the policy number.
[CUSTOMER][NEUTRAL] 02580767.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII].
[AGENT][NEUTRAL] Oh, I just spoke with him. OK. Well, all the information provided is a verification of benefits, not a guarantee of payment, and um I can also fax you over a copy of the fax back, but did you want to go over it?
[CUSTOMER][NEUTRAL] Um, would, would you mind if we could just go over it real quick? Would that be OK?
[AGENT][NEUTRAL] Sure. So on the fax back, um, you'll see the calendar year max and deductible, so it's $500 per covered insured per year.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] There is a $50 OK, OK.
[CUSTOMER][NEUTRAL] OK,
[CUSTOMER][NEUTRAL] I'm sorry, I just need um before I get to that, that's sort of like the last page unfortunately I have dropped down so it guides me um could I get um the effective date?
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] And the group name?
[AGENT][NEUTRAL] Group name.
[AGENT][NEUTRAL] Management
[AGENT][NEUTRAL] Analysis.
[AGENT][NEUTRAL] And utilization.
[CUSTOMER][NEUTRAL] And is there a group number?
[AGENT][NEUTRAL] Yes, ma'am, it's 70056.
[CUSTOMER][NEUTRAL] Alright and the um plan product name?
[CUSTOMER][NEUTRAL] No I got it on my phone. I got those scheduled in my. I just didn't know about.
[AGENT][NEUTRAL] Plan product name.
[CUSTOMER][NEUTRAL] Or like the fee schedule maybe?
[AGENT][NEUTRAL] So this is um just a a standard Carrington fee schedule. Um, yes, ma'am. It is on the PPO network.
[CUSTOMER][NEUTRAL] Carrington OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just trying to
[CUSTOMER][NEUTRAL] Get this down here.
[CUSTOMER][NEUTRAL] Alright, and can I get an address for the dental claims?
[AGENT][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Well, like I said,
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Just looking for this address.
[CUSTOMER][NEUTRAL] No it was [PII].
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Thank you. Is there a deductible?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Yes, it's $50 per person, up to $150 per family.
[CUSTOMER][NEUTRAL] And the Plan Max.
[AGENT][NEUTRAL] $500 per insured per year.
[CUSTOMER][NEUTRAL] Has anything been used?
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Um, for 2025, nothing has been used yet.
[CUSTOMER][NEUTRAL] OK and.
[CUSTOMER][NEUTRAL] For group coverage, diagnostic preventative, basic in nature.
[AGENT][NEUTRAL] The policy only covers preventative and basic.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And major for us um includes endodontic, periodontic, prosodontic, and oral surgery.
[CUSTOMER][NEUTRAL] If you
[CUSTOMER][NEUTRAL] And for basic coverage, how much does it cover up?
[AGENT][NEUTRAL] Um, basically it's at 80%.
[CUSTOMER][NEUTRAL] Is there a waiting period on it at all?
[AGENT][NEUTRAL] Um, there's no waiting period, um, because major is not covered.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Are there any frequencies for.
[CUSTOMER][NEUTRAL] The exam cleaning and the X-rays.
[AGENT][NEUTRAL] Um, trophies and cleanings are once every 6 months.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Evaluations are 2 for 12 months.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] Bite wings are once for 12 months?
[AGENT][NEUTRAL] And then full mouth X-rays and panels are once every 5 years.
[CUSTOMER][NEUTRAL] Alright, is there fluoride coverage at all?
[AGENT][NEUTRAL] Fluoride, let's see.
[AGENT][NEUTRAL] Um, there is coverage for fluoride under preventative.
[CUSTOMER][NEUTRAL] OK, and the frequency?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So if it's first, let me see D or G. Hold on one moment.
[AGENT][NEUTRAL] Um, one procedure for 12 months.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright, and can I just get um a reference number for our call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Have a great answer
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] Nope, that's all but thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. I hope you have a great week.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.