AccountId: 011433970860
ContactId: 518b26cd-00de-45d9-a629-d4da9240f681
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249250 ms
Total Talk Time (AGENT): 81733 ms
Total Talk Time (CUSTOMER): 90045 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/518b26cd-00de-45d9-a629-d4da9240f681_20250310T17:00_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][POSITIVE] Yes ma'am, I'm trying to get benefits and eligibility on a mutual patient.
[AGENT][NEUTRAL] OK. May I ask who's calling?
[CUSTOMER][NEUTRAL] This is [PII].
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[CUSTOMER][NEUTRAL] [PII] option 2.
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Um, that is gonna be 616.
[CUSTOMER][NEUTRAL] 540.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] Uh, it is [PII].
[AGENT][POSITIVE] Thank you, [PII], and you were just needing benefits.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I can help you with that. Do you want them over the phone or would you like a fax back?
[CUSTOMER][NEUTRAL] Um, if possible, I would like both.
[AGENT][NEUTRAL] What is your fax number?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I can fax that to you. Their effective date is [PII].
[AGENT][NEUTRAL] Any benefits given over the phone is not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] They have a $1000 calendar year maximum?
[AGENT][NEUTRAL] $50 deductible on everything except for exams and pricy.
[AGENT][NEUTRAL] Everything's paid on a fee schedule.
[CUSTOMER][NEUTRAL] OK, and are you going through Carrington?
[AGENT][NEUTRAL] Yes, ma'am. Uh, Carrington does our provider list only.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and is that with the PPO or is that the discount plan?
[AGENT][NEUTRAL] Uh, it's whatever you signed up with Carrington. I'm not sure. We don't have that information.
[CUSTOMER][NEUTRAL] OK, um
[CUSTOMER][NEUTRAL] So you said a $1000 deductible.
[AGENT][NEUTRAL] A $1000 calendar year maximum.
[CUSTOMER][NEUTRAL] Maximum I'm, I, I knew what I was trying to write, um, diagnostic and preventative is covered at 100% basic at 80 major at 50%.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] No, ma'am. Everything's paid on a fee schedule.
[AGENT][NEUTRAL] Each procedure code pays a flat amount.
[CUSTOMER][NEUTRAL] OK, so is this more or less of like a discount plan?
[AGENT][NEUTRAL] No, ma'am, it's insurance. It's just paid on a pay schedule.
[CUSTOMER][NEUTRAL] OK, on the FAO SRPs, can all four quads be done on the same day?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, on your dentures, bridges, and crowns, is that 1 in 51 in 7, or 1 in 10?
[AGENT][NEUTRAL] 1 in 5.
[CUSTOMER][NEUTRAL] Any downgrades on the policy?
[AGENT][NEUTRAL] We do not downgrade on anything.
[CUSTOMER][NEUTRAL] And is there a missing tooth crawls?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][POSITIVE] All right, I think that's gonna be all, and I thank you so much for your time today.
[AGENT][NEUTRAL] You're welcome and I'll fax you that, uh, fee schedule.
[CUSTOMER][POSITIVE] All right thank you so much.
[AGENT][POSITIVE] Thank you, [PII], for calling API. You have a good day.
[CUSTOMER][NEUTRAL] Alright you too bye bye.
[AGENT][NEUTRAL] Bye-bye.