AccountId: 011433970860
ContactId: 288f7dee-4a0a-4b89-9ebf-bed0e45dfc15
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 333540 ms
Total Talk Time (AGENT): 160146 ms
Total Talk Time (CUSTOMER): 122295 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/288f7dee-4a0a-4b89-9ebf-bed0e45dfc15_20250305T18:45_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi um my name is [PII]. I was just on the phone with someone before calling about insurance if we're a network or not and then she was gonna transfer me just so I can get a breakdown, um, of the services for that.
[AGENT][NEUTRAL] OK, well, I can 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] Yeah.
[CUSTOMER][NEUTRAL] Yes, uh, phone number is [PII], um, and that'll be option one.
[CUSTOMER][NEUTRAL] And then you said the policy number?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 025.
[CUSTOMER][NEUTRAL] 94573.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, yes, it is [PII].
[CUSTOMER][NEUTRAL] And then let me get the date of birth up again and date of birth is uh [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And um I do have the policy here. You said you needed a breakdown, so you were getting like the fax back faxed to you?
[CUSTOMER][NEUTRAL] Um, yeah, she said I was asking this, the person before if we were in or out of network with them they have their children that will be coming to see us and then she said she would transfer me just so someone could go over like basic major preventative, um, maximums, deductible, and all that.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Um, but I can do a fax back as well if that is better.
[AGENT][NEUTRAL] Well, it's up to you. Um, the information that we're gonna go over is, is the facts back. So if you, um, it, it's whatever you prefer, and I'm just pulling it up now. Hold on one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] And so the policy is on a PPO, the Carrington PPO network, but whether you're a Carrington provider or not, the benefits are still the same. They're just maybe like if you were a Carrington provider an additional percentage off the balance, if you're not, you just won't get that percentage, but the benefits are the same. Um, we don't have access to Carrington's list of providers, but I can give you their number or
[AGENT][NEUTRAL] Well, they don't have a website. I can give you their phone number, um, if you'd like to verify that with them, but I can go over the rest of the facts with you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK. Um, so hold on one second.
[AGENT][NEUTRAL] So the phone number for Carrington is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect.
[AGENT][POSITIVE] And again, just, oh, I'm sorry.
[CUSTOMER][NEUTRAL] And then they would be the number to call to see if we're in network.
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] OK, OK, awesome so it may be different from.
[CUSTOMER][NEUTRAL] On what she had told me the previous person.
[CUSTOMER][NEUTRAL] Um, so to call Carrington to see if we're a network or not.
[AGENT][NEUTRAL] Yes, um, we just don't have access to their list, but yes, it's Carrington.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Yeah, no worries, I can do that.
[CUSTOMER][POSITIVE] All right awesome thank you.
[AGENT][NEUTRAL] You're welcome. And then, um, so just again just for the call, all the information provided is a verification of benefits, not a guarantee of payment. So the calendar year max for this policy is up to $500 per covered insured.
[AGENT][NEUTRAL] Um, there is a $50 deductible. Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Alright, that's the
[CUSTOMER][NEUTRAL] Alright, no, no, you're OK, you said 500 max, um, per.
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] OK, and then $50 deductible.
[AGENT][NEUTRAL] Per person per calendar year.
[AGENT][NEUTRAL] Yes, up to 150 per family.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] The deductible does not apply to preventative?
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] Um, the policy covers preventative radiograph and FMX expenses and then basic expenses. There's no major, major for us includes endodontic, periodontic, prosodontic, and oral surgery.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][POSITIVE] The preventative is covered at 100%. All the others, the radiograph and basic, that's all covered at 80% and there's no waiting period.
[CUSTOMER][NEUTRAL] Alright, basic is 80% right.
[CUSTOMER][POSITIVE] All right awesome and then am I able to give you that fax back number as well just so I can.
[AGENT][NEUTRAL] Oh, sure. Um, what's a good fax number for you?
[CUSTOMER][POSITIVE] Have that yeah perfect.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And should I put attention, [PII]?
[CUSTOMER][NEUTRAL] Uh, yes, you can put that on there.
[AGENT][NEUTRAL] OK, and it was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Alright, so I'll go ahead and send this over to you now. And was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] Uh, no, that is it. Thank you very much for your help.
[AGENT][POSITIVE] Well, you're welcome, [PII], and thanks for calling APL. I hope you have a great evening.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.