AccountId: 011433970860
ContactId: 56eba323-1ad9-45d0-831a-a715c4f09717
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190009 ms
Total Talk Time (AGENT): 79604 ms
Total Talk Time (CUSTOMER): 83148 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/56eba323-1ad9-45d0-831a-a715c4f09717_20250127T18:43_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello, this is [PII]. I'm sorry. Uh, I'm a dental provider.
[CUSTOMER][NEUTRAL] I previously called regarding a patient's plan.
[CUSTOMER][NEUTRAL] Um, it's with American Public Life Insurance.
[CUSTOMER][NEUTRAL] Uh, with Carrington, yes, and I just.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Wanted to ask, well, we're not in network with the plan.
[CUSTOMER][NEUTRAL] However, this plan covers for preventative and basic. And I just wanted to know if the patient has to pay first, and if you would reimburse her.
[CUSTOMER][NEUTRAL] Or how's the process?
[AGENT][POSITIVE] OK, um, let me take a look at the policy and I'll be more than happy to assist you um with how everything is applied. Um, [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, the member's policy is 02584928.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] The first name is, well, OK. It's [PII] and the last name is [PII]. And the date of birth is
[CUSTOMER][NEUTRAL] Just a minute please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment.
[AGENT][NEUTRAL] Um, so the
[AGENT][NEUTRAL] You're not in network, so the benefits are the same whether you're in network or not. And then for the uh preventative and basic, what question did you have?
[CUSTOMER][NEUTRAL] Yes, um, my question is if the patient has to pay first?
[CUSTOMER][NEUTRAL] And the insurance will reimburse her, or how's the process?
[AGENT][NEUTRAL] It depends on, on your facility. So everything that we apply is on the back and once the claim is submitted. So if you're a facility that they have to pay to receive the service, then they will have to pay upfront. If it's where they can be billed or you know, you'll bill it, then once we receive the claim, we'll we'll process process and pay.
[AGENT][NEUTRAL] If we can.
[CUSTOMER][NEUTRAL] Oh, OK, so it can be through through the claims, right?
[AGENT][NEUTRAL] Right, we apply once the claim has been received and processed, then we apply. So most of the time that's after the services are done.
[CUSTOMER][POSITIVE] OK, alright, OK, thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] Um, no, that would be it, thank you.
[AGENT][POSITIVE] Alright, well, thanks so much for calling APL. I hope you have a great day, [PII].
[CUSTOMER][POSITIVE] You too bye bye thanks.
[AGENT][POSITIVE] Thank you. Bye-bye.