AccountId: 011433970860
ContactId: 248c883e-1042-4de7-8024-686b274afa51
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 311170 ms
Total Talk Time (AGENT): 119128 ms
Total Talk Time (CUSTOMER): 82067 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/248c883e-1042-4de7-8024-686b274afa51_20250401T21:18_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Crosby Dental Center.
[CUSTOMER][NEUTRAL] And I am trying to get some information on this plan for my patients.
[AGENT][NEUTRAL] OK [PII], I can help you with the plan information. Do you have a good call back number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] Let's see, his name is [PII].
[CUSTOMER][NEUTRAL] And his date of birth is [PII].
[AGENT][POSITIVE] Oh, and the policy number. I'm so sorry.
[CUSTOMER][NEUTRAL] Last name is
[CUSTOMER][NEUTRAL] Uh, policy number is 025796992.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And he is the patient, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And are you needing eligibility and benefits or?
[CUSTOMER][NEUTRAL] Well she said this is a discount plan, not insurance.
[CUSTOMER][NEUTRAL] I'm not sure what this is, so I'm trying to find out.
[AGENT][NEUTRAL] OK, so let me pull up the benefits, and this is not a guarantee of payment, it's a basic outline of the policy.
[AGENT][NEUTRAL] Can I place you on a brief hold real quick?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Go, go, go, go.
[AGENT][NEUTRAL] OK, thanks for holding. OK, let me pull up his policy.
[AGENT][NEUTRAL] Let's see
[AGENT][POSITIVE] So he's effective and active [PII].
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] I can send a dental fax back on this too um basically it's.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] It's gonna have a it has a $1500 plan year maximum benefit.
[AGENT][NEUTRAL] Uh, let's see, preventative services pay 100%.
[AGENT][NEUTRAL] Um, basic expenses pay 80% after a $50 calendar year deductible.
[AGENT][NEUTRAL] And then major endodontic periodontic, those pay 40%.
[AGENT][NEUTRAL] After a $50 calendar year deductible in which there is a 12 month waiting period.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] They're missing tooth cloths.
[AGENT][NEUTRAL] Yes, there is.
[CUSTOMER][NEUTRAL] OK, so this is an insurance not a discount plan, OK.
[CUSTOMER][NEUTRAL] Um, and what fee schedule do they use?
[AGENT][NEUTRAL] Uh, just based on what's reasonable and customary.
[CUSTOMER][NEUTRAL] Is it a PPO plan?
[AGENT][NEUTRAL] Um, I don't, let me see if they use Carrington.
[AGENT][NEUTRAL] Um, let's see here
[AGENT][NEUTRAL] Um, I don't show that, no.
[AGENT][NEUTRAL] So they can go to any dentist they want.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They can go to any dentist.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, um, is there a claims mailing address?
[AGENT][NEUTRAL] Yes, claims mailing address is [PII].
[AGENT][NEUTRAL] And that's [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 8950 and do they have electronic?
[CUSTOMER][NEUTRAL] Uh, claims also?
[AGENT][NEUTRAL] Yes, we have a payer ID it's 60801.
[CUSTOMER][NEUTRAL] We use our standard fee schedules.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And the insurance company is American Public Life.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, and can you fax over their benefits?
[AGENT][POSITIVE] Absolutely. What's your fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And put that to your attention, [PII].
[CUSTOMER][NEUTRAL] Uh, it doesn't matter, it's just two of us here.
[AGENT][POSITIVE] OK, OK, give me just a few moments. I'll get that faxed over, and is there anything else I can help with today?
[CUSTOMER][NEUTRAL] That is all.
[AGENT][POSITIVE] OK, thank you for calling APL have a great day.
[CUSTOMER][POSITIVE] Thank you bye.
[AGENT][NEUTRAL] Bye.