AccountId: 011433970860
ContactId: 275dc8f1-d7d5-4959-b053-07f04140d635
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 493380 ms
Total Talk Time (AGENT): 144925 ms
Total Talk Time (CUSTOMER): 112996 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/275dc8f1-d7d5-4959-b053-07f04140d635_20250505T16:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from a dental provider's office. I was trying to see if you could assist me with, um, seeing my patient has any dental coverage.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you, um, as far as benefits for the patient and eligibility, can I get your callback number, ma'am, just in case our call is just disconnected.
[CUSTOMER][NEUTRAL] Uh, yeah, callback number is [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what's the name of your facility?
[CUSTOMER][NEUTRAL] Smiley Dental and orthodontics.
[AGENT][NEUTRAL] OK. And may I get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, it's for [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] And um the only thing I have is her social.
[AGENT][NEUTRAL] OK, what is that, please?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, let me look it up.
[AGENT][NEUTRAL] OK, and can you repeat the name for me one more time please?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, I see you're right here.
[AGENT][NEUTRAL] All right. I do show that [PII] does have an active policy with us and the effective date of the policy is [PII].
[AGENT][NEUTRAL] And if you want to give me your fax number, I can send you a fax back with her benefit breakdown and fee schedule.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, um, it's gonna be 214.
[CUSTOMER][NEUTRAL] 367.
[CUSTOMER][NEUTRAL] 621 7
[AGENT][POSITIVE] OK, Ms. [PII], I'm gonna put you on a quick hold while I get that fax ready for you and I'll be right back with you.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you, Ms. [PII] for holding for me. I have that fax on its way to you now, ma'am.
[CUSTOMER][NEUTRAL] OK, um, I do have a few questions. Would you be able to help me out with those?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, um, would you be able to tell me if my, well, what kind of plan this is first?
[AGENT][NEUTRAL] Uh, this is American Public Life. Um, it's participates with Carrington, although, uh, the patient doesn't have to utilize the Carrington providers.
[CUSTOMER][NEUTRAL] OK, um, would I be, would I be able to give you my provider's information?
[AGENT][NEUTRAL] They can go to any provider they choose to go to.
[CUSTOMER][NEUTRAL] And then we can see if she's the network.
[CUSTOMER][NEUTRAL] OK, OK, um.
[AGENT][NEUTRAL] They don't have to go into a specific network they can use anybody.
[CUSTOMER][NEUTRAL] OK, and then we would just be using UCR fees?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and um so this is a PPO plan?
[AGENT][NEUTRAL] No, it's not a PPO.
[CUSTOMER][NEUTRAL] OK, uh, what kind of plan would it be considered?
[AGENT][NEUTRAL] It does, it does because it's um a standalone plan through American public life.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] And this payment go to us or to the patient?
[AGENT][NEUTRAL] It'll go to you if you're the one filing the claim.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] And are there any downgrades on this plan at all?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK, um, is there a missing tooth claws or any waiting periods?
[AGENT][NEUTRAL] Yes, and that's also on your fax back when you get it um it does have a missing tooth claws and uh.
[AGENT][NEUTRAL] There is no waiting period.
[CUSTOMER][NEUTRAL] OK, um, would you be able to give me the member ID number or would I just use the um the social?
[AGENT][NEUTRAL] Oh yes, um, no, let me give you that. I should have already done that. Um, the policy number is 261.
[AGENT][NEUTRAL] 0835.
[CUSTOMER][NEUTRAL] OK, and then, um, would you be able to provide me with the payer ID and the group number?
[AGENT][NEUTRAL] Yes, ma'am, um, the payer ID number is 60801.
[AGENT][NEUTRAL] And the group number.
[AGENT][NEUTRAL] is 70055.
[CUSTOMER][NEUTRAL] OK, um, alright, well that'll be all then I'll go ahead and um wait for that fax. If I can just get the reference number and your name again please.
[AGENT][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] And you can use my name and today's date for your reference.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] OK, alright, well thank you so much for your help.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. I hope you have a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] Mhm thank you.