AccountId: 011433970860
ContactId: 4a17bfa0-dcfb-46e2-978f-24d149328789
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266390 ms
Total Talk Time (AGENT): 149942 ms
Total Talk Time (CUSTOMER): 89700 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/4a17bfa0-dcfb-46e2-978f-24d149328789_20250325T15:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I'm calling to find out if our providers are in or out of network for a patient's dental benefits and also what their maximum is.
[AGENT][NEUTRAL] Sure I can check that benefit information and uh what network they might be a part of um what was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] It looks like 02592622.
[AGENT][NEUTRAL] OK, and uh what was the name and date of birth for the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Perfect. OK, thank you for verifying that. Uh, so this policy is active. Effective date was [PII].
[AGENT][NEUTRAL] Bear with me just a moment, let me get this pulled up.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So this policy, uh, it does participate in the Carrington PPO network, um, however, the utilization of a provider within the network is not required, uh, they just receive a discount if it's through Carrington, um, and then of course I will let you know verification of coverage is not a guarantee of payment for claims. uh, their calendar year maximum is $500 per covered member.
[AGENT][NEUTRAL] Uh, $50 deductible, um, does not apply to preventative, uh, services.
[AGENT][NEUTRAL] And then if you'll give me one moment, I'll see if I'm sorry.
[CUSTOMER][NEUTRAL] Does not apply to
[CUSTOMER][NEUTRAL] Mhm, no go ahead I was just listening.
[AGENT][NEUTRAL] No, that's OK um OK and I did just check none of that has been used so far this year.
[CUSTOMER][NEUTRAL] OK, so they do have
[AGENT][NEUTRAL] And if you would like, I can send you this fax box, uh, that does show all of the covered benefits, uh, and, and, uh, all of that information.
[CUSTOMER][POSITIVE] Yes, that would be great, um, and it looks like the coverage for this just 100 for some things and then 80% for others.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Correct, so in short this policy does not offer any sort of major coverage. Um, it is strictly uh preventative and basic, so preventative is at 100, uh, radiographs basic, uh, those are going to be at 80.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] OK and uh what was that fax number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK alrighty I will go ahead and get that sent to you um did you have any other questions for me?
[CUSTOMER][NEUTRAL] Yes, um, the birthday [PII] [PII], is he also on this plan?
[AGENT][NEUTRAL] Uh-huh
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] That is a cover dependent. Uh-huh.
[CUSTOMER][NEUTRAL] The spelling of that I'm not sure if I have it correct because patient has such an accent um.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII], is that right or is it [PII]?
[AGENT][NEUTRAL] That is not what I've got. Yeah, I've got it as [PII] [PII] [PII] [PII] [PII] [PII]
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, perfect. OK, thank you so much for that because I wasn't sure I was guessing.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] No, I, I completely understand.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Alright, was there anything else I can help you with?
[CUSTOMER][POSITIVE] Alrighty I'll be looking.
[CUSTOMER][NEUTRAL] Um, just a reference number.
[AGENT][NEUTRAL] All right, yeah.
[AGENT][NEUTRAL] Uh huh. Uh, that would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII]
[AGENT][NEUTRAL] And I just sent that fax back. You should be getting it within, I would say about within 10 minutes.
[CUSTOMER][POSITIVE] Perfect sounds good thank you so much.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you bye bye.