AccountId: 011433970860
ContactId: 53085e54-580c-4eb3-831d-41ec729570ae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 364130 ms
Total Talk Time (AGENT): 121046 ms
Total Talk Time (CUSTOMER): 122035 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/53085e54-580c-4eb3-831d-41ec729570ae_20250403T16:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi there, I am calling because I have a patient that has he has dental benefits and just trying to figure it out because I've never heard of American Public Life and just trying to figure out for a network and what's going on.
[AGENT][NEUTRAL] OK, I can help you with benefits and eligibility for the patient. Can you please give me, you're welcome, can you please give me your name and your callback number facility you're calling from?
[CUSTOMER][POSITIVE] Thank you appreciate it.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. Callback number is [PII].
[CUSTOMER][NEUTRAL] And I am calling from Premier Dental Partners downtown [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yeah, so name is [PII]. You want me to spell that for you?
[AGENT][NEUTRAL] No, sir. I've got it. And then what, OK.
[CUSTOMER][NEUTRAL] OK. Date of birth is [PII].
[CUSTOMER][NEUTRAL] And then the policy is 02573519.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're very welcome. OK, I do show that [PII] does have an active policy with us and his effective date is [PII].
[AGENT][NEUTRAL] Um, if you send, give me your fax number, I can send you a fax back with this benefit breakdown along with the fee schedule.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, perfect, um, and then do you, what network do you guys utilize?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] We utilize Carrington but it doesn't have to be um.
[AGENT][NEUTRAL] Through Carrington, it's through American public, right, it doesn't have to be in the network. They can use anybody they want to use.
[CUSTOMER][NEUTRAL] In that work with him.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, because
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it. OK, so there's really no true network, but you do utilize Carrington's.
[AGENT][NEUTRAL] Right, but the, right.
[CUSTOMER][NEUTRAL] Doctor network
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so there's no like in network out of network fees essentially it's just the fees.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right, we go by UCR.
[CUSTOMER][NEUTRAL] Everybody's in network essentially.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, yeah, I can, are, are you ready for the fax number?
[AGENT][NEUTRAL] I am.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. All right. I'm gonna put you on a quick hold, [PII], while I get this fax ready for you and I'll be right back.
[CUSTOMER][POSITIVE] Thank you, ma'am.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you so much for holding for me [PII] I have that fax on its way to you now.
[CUSTOMER][POSITIVE] OK fantastic and then Question, like is there a maximum on this plan?
[AGENT][NEUTRAL] Yes sir, that's on your fax back um I can let you know what it is real quick though and this is just to verify benefits it's not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] He does have a calendar year maximum of $500 and a calendar year deductible of 50 $50.
[CUSTOMER][NEUTRAL] $50 deductible, OK, and is the payer ID on there?
[AGENT][NEUTRAL] Yes, sir, and also the um claims mailing address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK perfect and do you guys select, uh, do you guys accept electronic submissions?
[AGENT][NEUTRAL] Yes sir, um, let me give you the payer ID.
[CUSTOMER][NEUTRAL] For plans, OK.
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] 60801. OK perfect.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty, alright, thank you so much. I appreciate your help.
[AGENT][POSITIVE] You're very welcome. Is there, that's no problem. Can I help you with anything else before we go?
[CUSTOMER][NEUTRAL] Uh, no, ma'am, that's all for today.
[AGENT][POSITIVE] OK, well you have a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you, you too, ma'am.
[AGENT][NEUTRAL] Bye bye, sir.
[CUSTOMER][NEUTRAL] Alright bye bye.