AccountId: 011433970860
ContactId: 286ba11a-d3da-4c99-b5e4-7217aaf66631
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202419 ms
Total Talk Time (AGENT): 95288 ms
Total Talk Time (CUSTOMER): 91357 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/286ba11a-d3da-4c99-b5e4-7217aaf66631_20250305T13:21_UTC.wav
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[AGENT][NEUTRAL] APL this is [PII]. How may I help you?
[CUSTOMER][NEGATIVE] Hi, my name is [PII]. I'm with the provider's office, and I'm just trying to get a breakdown of benefits on a patient if possible.
[AGENT][NEUTRAL] OK, your dental provider's office?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I can help you, [PII]. What's the policy number and a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, um, you said the policy number is that is 02582695.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And my telephone number is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, it's [PII] and her birthday is [PII].
[AGENT][NEUTRAL] Alright, thanks for that information. Effective date is [PII]. Uh, policy is active at this time and you say that you would like to schedule a benefits faxed over.
[CUSTOMER][NEUTRAL] Um, yeah, uh, I guess I can do that and then any more questions, I guess I'll call back and ask specifics.
[AGENT][NEUTRAL] OK, it's a detailed breakdown. Let me get your uh fax number first so that I'll give you the information that's gonna be on the schedule.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, um, it is uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 6033.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You don't show any claims received so far.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And on the schedule.
[AGENT][NEUTRAL] Uh, it's gonna include the calendar, your maximum deductible information, um, the frequencies, common limitations, exclusions, uh, claims mailing address, payer ID number, fax number, um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It'll give you the, you know, the amounts that it's payable 100% preventive 80 basic, um, major is not covered under this policy, so you will not see any of those codes, um, the limitations and exclusions are on the on the last page.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And also if you do not see um the procedure code that's that means it's not covered um by this policy.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Is it like a certain network?
[AGENT][NEUTRAL] Um, Carrington, uh, PPO is the network.
[CUSTOMER][NEUTRAL] OK and then um so on the card itself it says American Public Life, but it also says Carrington Benefit solution so who do we need to make the claims like to what's the actual insurance name?
[AGENT][NEUTRAL] You know, you'll submit the claim to American Public Life. Carrington is the PPO network of providers, not the insurance company.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK, we've just never had one of these, so I've never heard of it, so I just wanted to make sure because like I said we have the Carrington benefit solutions all the time, but I've never seen American public life, so I just wanted to triple check with that. So alrighty perfect well I will just wait for that fax. Do you know if it takes like 24 hours or if it's like.
[AGENT][NEUTRAL] OK. OK. OK.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, no, no, no, no. You should receive it within the next 5 to 7 minutes.
[CUSTOMER][POSITIVE] Oh, even better.
[CUSTOMER][POSITIVE] OK, that's perfect because she just comes in tomorrow afternoon so I just wanted to make sure all right great thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Anything else, [PII], I can help out with today?
[CUSTOMER][POSITIVE] Uh, no, ma'am, that's it. Thank you.
[AGENT][POSITIVE] You're welcome thanks for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Yes ma'am you too bye bye.