AccountId: 011433970860
ContactId: 60894882-82f5-41ed-8290-4a29878d2e8d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 500809 ms
Total Talk Time (AGENT): 234368 ms
Total Talk Time (CUSTOMER): 161844 ms
Interruptions: 5
Overall Sentiment: AGENT=1.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/60894882-82f5-41ed-8290-4a29878d2e8d_20250331T12:22_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, good morning. My name is [PII]. I'm calling from a provider's office. How are you today?
[AGENT][POSITIVE] I'm good, [PII]. How are you doing?
[CUSTOMER][NEUTRAL] I'm good, thank you. I am trying to, well, I'm trying to find out about a patient's dental plan, please.
[AGENT][POSITIVE] Good. Well, how can I help you?
[AGENT][NEUTRAL] OK. Uh, so you're needing eligibility and a fax back of the benefits?
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes ma'am, I can help you with those things and [PII], what is a good call back number for you please?
[CUSTOMER][NEUTRAL] It's [PII] no extension.
[AGENT][NEUTRAL] OK, thank you and the member's policy number?
[CUSTOMER][NEUTRAL] Well, it's 02550384.
[AGENT][POSITIVE] OK, thank you so give me a couple of moments please to get the.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Numbers information pulled up.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And any information, Ray that I do for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name again and their date of birth?
[CUSTOMER][NEUTRAL] [PII] and of [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, thank you. So I do show that he is the subscriber on this general policy and his payment is active.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] With an effective date of [PII].
[CUSTOMER][NEUTRAL] Is this an in
[CUSTOMER][NEUTRAL] [PII] of when?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Is this like an individual plan?
[AGENT][NEUTRAL] It is, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I guess I need to ask, do you show, uh, Doctor [PII] in network or out?
[AGENT][NEUTRAL] Now this network plan rather participates with the Carrington PPE.
[AGENT][POSITIVE] Yeah network, however, they are not required to utilize in there, but if you need Carrington's phone number, I'll be happy to come, I'll give you that number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] No, that's fine. That's fine. No. No.
[AGENT][NEUTRAL] That you could reach out to them if you have any questions, OK, OK.
[CUSTOMER][NEUTRAL] OK. So it's American Public Life is the name of it?
[AGENT][NEUTRAL] And then
[AGENT][POSITIVE] Yes ma'am. That is correct.
[AGENT][NEUTRAL] And on the fax facts that I will.
[CUSTOMER][NEUTRAL] Alright, does it have a group number?
[AGENT][NEUTRAL] It does. 70056, which should also be on his ID card.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and what were you saying about the fax?
[AGENT][NEUTRAL] I was just gonna say that on the fax back, anything that is not, not be covered, and it also has our mailing address, fax number and payer ID information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, will it list his history?
[AGENT][NEUTRAL] There is no history on file for this member?
[CUSTOMER][NEUTRAL] OK. What about waiting periods on the facts?
[AGENT][NEUTRAL] There are no, yes, that would be on there, but there is no waiting periods on this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, all right.
[CUSTOMER][POSITIVE] Oh no worries.
[AGENT][POSITIVE] Correct, yes ma'am.
[CUSTOMER][NEUTRAL] OK. Does it tell whether or not there's a missing tooth cloth?
[AGENT][NEUTRAL] It does.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. Do you need my fax number?
[AGENT][NEUTRAL] And there is. Mhm.
[CUSTOMER][NEUTRAL] There is, OK.
[AGENT][NEUTRAL] Yes ma'am
[CUSTOMER][NEUTRAL] Alright, the, uh, fax number is [PII].
[AGENT][NEUTRAL] And give me just one moment. Yes, the fax is.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You can go ahead and give it to me while it's loading.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and does it need to be put to your attention, [PII], or is that not necessary?
[CUSTOMER][NEUTRAL] No, it comes straight to me. Mm. No, it's not necessary.
[AGENT][NEUTRAL] It comes straight to you. OK. All right, so just one moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And again, you said your fax number is 7.
[AGENT][NEUTRAL] [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct, yes. Mhm.
[AGENT][POSITIVE] OK. Well, I have just sent that to you, [PII], so provided there's not any type of technical mishap, you should be receiving that within just the next several minutes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Let me ask that, sometimes I don't catch this. On the [PII], the limited exam, can you do treatment on the same day?
[AGENT][NEUTRAL] It's limited to two oral evaluation procedures in any 12-month combination. That's with 0120 and 0150 and 0160 for 12 month period. Um, and let me see if there's another one.
[AGENT][NEUTRAL] No, and that's, that's the only limitation.
[CUSTOMER][POSITIVE] OK, so, OK. You are awesome, thank you. Uh, may I have a reference number?
[AGENT][NEUTRAL] Well, you are certain.
[AGENT][NEUTRAL] Yes ma'am, you would use my name along with today's date and then one additional thing [PII], um, once the claim has been processed with APL we do have a portal in which you should be able to check claim status and our portal website address is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh, is it secured like [PII]?
[AGENT][POSITIVE] That is correct, yes ma'am.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] OK, alright, you are wonderful thank you may I have a reference number?
[AGENT][NEUTRAL] Mhm. Oh, yes, ma'am. You're gonna use my name along with today's date.
[CUSTOMER][NEUTRAL] Oh yeah, I asked you that. It's early and it's Monday. My brain is still, I think I'm still asleep.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK. That's OK. Um, I can relate to that.
[CUSTOMER][POSITIVE] I hope you have a wonderful.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh yeah, I need some more coffee.
[AGENT][POSITIVE] Right, that works too.
[CUSTOMER][POSITIVE] I hope you have a wonderful Monday. Thank you.
[AGENT][POSITIVE] Well, thank you. I hope you do too, [PII]. Is there anything else I can help you with this morning?
[CUSTOMER][POSITIVE] No, you're awesome. Thank you, bye.
[AGENT][POSITIVE] Well, that's a sweetie you say. OK, thank you again for calling APL. You're welcome. Bye-bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Alright bye.