AccountId: 011433970860
ContactId: 39ab878e-8160-4417-bb52-c38fa703278e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 417859 ms
Total Talk Time (AGENT): 183064 ms
Total Talk Time (CUSTOMER): 91549 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/2025/02/28/39ab878e-8160-4417-bb52-c38fa703278e_20250228T14:30_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hold on one second, I'm sorry.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Hey, are you still there?
[AGENT][NEUTRAL] I am still here.
[CUSTOMER][POSITIVE] OK. I'm so sorry.
[AGENT][POSITIVE] That's all right. I understand, not a problem. How can I help you? I'm sorry.
[CUSTOMER][NEUTRAL] I need to
[CUSTOMER][NEUTRAL] I just need to check the remaining benefits and deductible and see if my patient is eligible for a few things.
[AGENT][POSITIVE] It would be my pleasure to assist you. May I ask your name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And what is a good callback number, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. What is the patient's policy number?
[CUSTOMER][NEUTRAL] It is 02439608.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and it's [PII].
[AGENT][NEUTRAL] All right, thank you, and I can help you with eligibility for [PII]. I'm showing her policy is active as of [PII].
[CUSTOMER][NEUTRAL] OK, and what's the remaining or yeah, what's the remaining benefits and deductible?
[AGENT][NEUTRAL] For
[AGENT][NEGATIVE] For [PII], she has not used any of her benefits nor used uh met her. I'm sorry, I've got fatty tongue. She's not used to any benefits and still has a deductible remaining.
[CUSTOMER][NEUTRAL] OK, and what's the, um, total benefits and deductible?
[AGENT][NEUTRAL] Have, have you received a breakdown?
[CUSTOMER][NEUTRAL] I have not.
[AGENT][NEUTRAL] Would you like for me to fax you a breakdown?
[AGENT][NEUTRAL] It's got the calendar, your max deductible frequencies and all that listed.
[CUSTOMER][NEUTRAL] Yeah, could I
[CUSTOMER][NEUTRAL] Yeah, could I get that and then ask you, um, just see if they're eligible for cleaning and.
[CUSTOMER][NEUTRAL] Um, exam in for I.
[AGENT][POSITIVE] Sure. Let me just get all that pulled up. I'll be happy to assist you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me um take care of this real quick. Is, are they in the office?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Let me get this fax back ready for you and get that on the way for you and this will answer a lot of your questions.
[AGENT][NEUTRAL] 243-9608. Now the policy does part it'll say that it participates in the Carrington PPO network, but network participation is not required, just to let you know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Excuse me, I'm so sorry, and [PII], what is the fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And just to verify that is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm so sorry. Hang on just a 2nd. [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so [PII]'s history, let's take a look.
[AGENT][NEUTRAL] On [PII], she had a prophy and bite wings and oral examination.
[CUSTOMER][NEUTRAL] OK, is she able to have another um exam cleaning?
[AGENT][NEUTRAL] I'm checking the frequency on that.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Propies are once every 6 months. Now, she had, let's see if she had another propy. She
[AGENT][NEUTRAL] Had her first trophy was on [PII] I'm sorry, [PII].
[AGENT][NEUTRAL] And then her second trophy was on [PII], [PII], so it's once every 6 months, so she should be eligible for that.
[AGENT][NEUTRAL] Profy or evaluation is 2 for 12 month period.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And did you need bite wings as well?
[CUSTOMER][NEUTRAL] Uh, no, I just need to see if she's eligible for fluoride.
[AGENT][NEUTRAL] No history for fluoride.
[CUSTOMER][NEUTRAL] OK, and is there an age limit?
[AGENT][NEUTRAL] It is under the age of [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And then I also have her.
[CUSTOMER][NEUTRAL] I also have her sister.
[AGENT][NEUTRAL] OK, let's take a look at it.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Do you need a breakdown for [PII] or do you, it's the same benefits as [PII]?
[CUSTOMER][NEUTRAL] No, I just
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is, I just need to know if she's eligible for cleaning exam in fluoride.
[AGENT][NEUTRAL] Let's see what her history is.
[AGENT][NEUTRAL] Probably gonna be the same.
[AGENT][NEUTRAL] It is exactly the same.
[AGENT][NEUTRAL] Her history.
[CUSTOMER][NEUTRAL] OK, and then
[CUSTOMER][NEUTRAL] Also one more question, um, if we are out of network, do y'all pay us directly?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] You would just use your fee schedule and it pays at a percentage. Preventive is 100% and basic is 80%. Majors not covered under this plan.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right perfect thank you so much.
[AGENT][POSITIVE] It's such a pleasure to assist you with that eligibility. [PII], thank you for calling APL. Hope you have a wonderful weekend. You should be receiving that fax any moment.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you, [PII]. Take care. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.