AccountId: 011433970860
ContactId: 189d63cc-a426-4dee-a2d2-b46146193373
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 291910 ms
Total Talk Time (AGENT): 165755 ms
Total Talk Time (CUSTOMER): 85178 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/189d63cc-a426-4dee-a2d2-b46146193373_20241230T20:11_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from a dental provider's office and I'm calling to get some information about a patient's uh plan.
[AGENT][POSITIVE] It would be my pleasure to assist you. Do you mind spelling your name for documentation purposes?
[CUSTOMER][NEUTRAL] Sure, [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the um phone number in case we get disconnected?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] 02502130.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you, and it would be my pleasure to assist you with information regarding this.
[AGENT][NEUTRAL] [PII]'s policy.
[AGENT][NEUTRAL] I do have that policy pulled up. And how can I help you, [PII]?
[CUSTOMER][NEUTRAL] So first um she wasn't really sure what the name of it was and I was trying to find out first of all I was trying to find out if we're in or out of network.
[AGENT][NEUTRAL] OK, I can help you with that. Well, her policy is active as a 6-17-24. The policy does participate in the Carrington PPO network, but it is not required. We pay both in and out of benefits, in and out of network benefits the same.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, but could you couldn't tell me if we were in or out of network?
[AGENT][NEUTRAL] If you're in the Carrington PPO network, then you would use the Carrington fee schedule. If not, then use your, your fee schedule and we pay accordingly and I do have a breakdown I can send to you if you'd like.
[CUSTOMER][POSITIVE] Oh, that would be great, yes.
[AGENT][NEUTRAL] Let me just make sure I spell her last name correct, bear with me just one second.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] [PII] And this policy.
[AGENT][NEUTRAL] Um, on the fax back you're gonna get the calendar year max, deductible, frequencies, limitations, billing information. If the procedure is not listed, it's not covered. This is a limited dental policy. It does not cover any major procedures, only preventive and basic.
[CUSTOMER][NEUTRAL] Oh, so it's just
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you for that.
[AGENT][NEUTRAL] And on the fax back, it does not include the group name and number, which I would be happy to provide that for you if you need it.
[CUSTOMER][NEUTRAL] Sure, go ahead.
[AGENT][NEUTRAL] Let me get that pulled up.
[CUSTOMER][POSITIVE] Thanks.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] The group number is 70052.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Group name is Oxford Global Resources.
[CUSTOMER][NEUTRAL] OK, now she told me um.
[CUSTOMER][NEUTRAL] She told me first she said it was American public life.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Does that
[CUSTOMER][NEUTRAL] So what is that?
[AGENT][NEUTRAL] That is the name of the insurance, American Public Life.
[CUSTOMER][NEUTRAL] Oh, I see. So the name of the insurance is American Public Life and the plan name is Oxford Global Resources.
[AGENT][NEUTRAL] The Oxford Global Resources is the group name.
[CUSTOMER][NEUTRAL] The group name got you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, great.
[AGENT][NEUTRAL] And on that fax back you'll get the calendar max deductibles, frequencies, limitations you'll also get our billing information and um the procedures listed that are covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What is that fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And just to verify that fax number I'm sending this to [PII].
[CUSTOMER][NEUTRAL] Yes, and you could send it to me to [PII].
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK. That is on the way for you, [PII]. Is there anything else I can help? I'm sorry?
[CUSTOMER][POSITIVE] Great
[CUSTOMER][POSITIVE] No, that's it thank you so much I appreciate it.
[AGENT][POSITIVE] Oh, I thought you said wait you said great. I got you.
[CUSTOMER][NEGATIVE] Oh no, no, no.
[AGENT][NEUTRAL] I'm like, what?
[CUSTOMER][NEUTRAL] No, no
[AGENT][POSITIVE] Well, it has been a pleasure to assist you with that breakdown, [PII]. You should be receiving that fax in just a few minutes and call us if you have any questions regarding the fax.
[CUSTOMER][POSITIVE] OK, great.
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] My pleasure and thank you for calling APLA. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thanks you too bye bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.