AccountId: 011433970860
ContactId: 3dd9a729-5c9d-44a5-845f-add1073b87d1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258640 ms
Total Talk Time (AGENT): 129121 ms
Total Talk Time (CUSTOMER): 83563 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/3dd9a729-5c9d-44a5-845f-add1073b87d1_20250108T17:23_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I need to verify a patient's dental plan.
[AGENT][POSITIVE] OK, well, I'll be more than happy to verify the plan for you. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] My name is [PII] and the office number is [PII].
[AGENT][NEUTRAL] Thank you for that, and [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] Um, I have a member ID, a Carrington member ID.
[AGENT][NEUTRAL] Does it start with a 01 or 02?
[CUSTOMER][NEUTRAL] Um, [PII], can I see that card again? There's like 5 consecutive zeros.
[CUSTOMER][NEUTRAL] And then hold on I'm pulling it up.
[AGENT][POSITIVE] Mhm. Take your time.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Oh actually never mind it's actually 0257.
[CUSTOMER][NEUTRAL] 653-3.
[AGENT][POSITIVE] Thank you for that. 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] [PII], his date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active, it has been effective since [PII]. And you said you just want to know the plan type?
[CUSTOMER][NEUTRAL] Well, I need to verify his benefits. I don't, I called Carrington. I thought it was through Carrington, um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I understand. I, I just want
[CUSTOMER][NEUTRAL] Are y'all able to send me a breakdown of benefits?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Are you able to send me a fax back a breakdown of benefits?
[AGENT][NEUTRAL] Yes, I just, when you said verify the, the plan, I didn't know what you meant by that. I was just trying to get some clarity, but yes, I can fax you the fax back. What's a good fax number for you?
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Hold on one moment. It sounds it sounds like static. Can you say that one more time for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And should I put attention, [PII]?
[CUSTOMER][NEUTRAL] Uh yes ma'am.
[AGENT][NEUTRAL] OK, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, and I'm faxing that to you now. Um, so on the fax back, you'll see the calendar year, um, max deductible, all the uh percentages and frequencies, exclusions, the three ways to file a claim, and then there's a list of covered codes on here. If the code you're looking for is not here, it's not covered by this policy. They also, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] are on the Carrington PPO network. However, if your doctor or dentist is not a Carrington provider, the benefits are still the same.
[CUSTOMER][NEUTRAL] OK awesome and then I am gonna ask you a couple questions for an SRP 4341 is are all four quotes covered in the same day?
[AGENT][NEUTRAL] Um, so this policy covers preventative and basic. There's no major coverage on this policy. For us, major includes periodontic, endodontic, prosteodontic, and oral surgery.
[CUSTOMER][NEUTRAL] OK, so all the pretty much it just covers exam X-rays, prophy, and fillings.
[AGENT][NEUTRAL] Um, bite wings, um, full mouth X-rays and panels, seal, I mean, it covers more than that, it just doesn't cover major.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Are extractions considered basic or major?
[AGENT][NEUTRAL] Um, 407,140 is considered a basic extraction.
[AGENT][NEUTRAL] That's the only extraction that's uh listed on this fax bag.
[CUSTOMER][NEUTRAL] And is that covered at 80%?
[AGENT][NEUTRAL] Yes, basically is 80.
[CUSTOMER][POSITIVE] Alrighty thank you so much.
[AGENT][POSITIVE] You're welcome, [PII], and I just sent that to you, so you should be receiving that shortly. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] No ma'am, that's it.
[AGENT][POSITIVE] Alright, well thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye bye.