AccountId: 011433970860
ContactId: 63cecdea-d0bc-4ae2-a80f-1f091a62b84a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 473399 ms
Total Talk Time (AGENT): 280953 ms
Total Talk Time (CUSTOMER): 287035 ms
Interruptions: 19
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/63cecdea-d0bc-4ae2-a80f-1f091a62b84a_20250313T18:37_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, um, this is [PII]. Um, I actually looked on the website for like the dentist under the plan, and I'm at one of them, but I don't like to know the, the name of you guys or like what to tell them, what information to give them.
[AGENT][NEUTRAL] OK, Mr. [PII], so you're trying to find out like your policy number and the information to give to your dental?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] No, I have my.
[CUSTOMER][NEUTRAL] I have my policy number. They're just asking like which, what are you guys basically.
[AGENT][NEGATIVE] I don't understand the question.
[CUSTOMER][NEUTRAL] Are like they're saying like are you a PPO or HMO cause they're trying to find you on there.
[AGENT][NEUTRAL] OK, I will have to look up.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] Yes, sorry, go ahead, say it again.
[AGENT][NEUTRAL] So, Mr. [PII], in order to um in order to be able to answer your question as to what type of policy you have, I'll have to pull up your policy information first and verify some things with you for security. So first off, what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]? Oh OK, OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And then your policy number, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes 250-132-2.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] sorry.
[AGENT][NEUTRAL] OK, so first off, Mr. [PII], any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your date of birth?
[CUSTOMER][NEUTRAL] Yeah, right.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you. Also your home mailing address, please.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] You say, say it again.
[AGENT][NEUTRAL] What is your home mailing address?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, I had just changed it. It should be [PII].
[AGENT][NEUTRAL] OK, thank you. The phone number that we have on file for you is the same as the one you gave me, so that is your best contact number, is that correct?
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Bye
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. And then lastly, um, your email address, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. So, Mr. [PII], first off, have you ever set up your profile in our portal so you can have access to your ID cards and policy information online?
[CUSTOMER][NEUTRAL] Right right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What was your question? Um, I don't know.
[AGENT][NEUTRAL] OK, I do, I will email you the user guide so that when you have a moment you can set that up. Um, the email that you're gonna receive from me will come from care team at [PII], Mr. [PII], and I will put APL in your subject line so that that's easy for you to recognize, OK? And I'll send you that email once we're done with our call, OK?
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't think so [PII]. I think we should.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now this dental plan that you have, it is not a network plan. We are not, this policy is not affiliated with any network. You may go to any provider of your choosing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But how old I so much, how would I tell them so they know.
[CUSTOMER][NEUTRAL] Like, what information do I give them?
[AGENT][NEUTRAL] OK, you can provide them with your policy and your policy number and our phone number and they can call to verify any information for you.
[AGENT][NEUTRAL] And then we can answer any questions that they may have, but this is not a network plan. You may choose any provider. You said that you're there now?
[CUSTOMER][NEUTRAL] So they
[CUSTOMER][NEUTRAL] Yeah, I'm here now talking to him.
[AGENT][NEUTRAL] OK. Well, if you want to tell them that.
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] OK. Uh, what number would I give them?
[AGENT][NEUTRAL] 1800.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I have a verified benefits and patient eligibility number. I think it's time is 1-800. 256-256 818606 860606
[AGENT][NEUTRAL] 256-860-6.
[AGENT][NEUTRAL] Yes, sir. I mean, if you want to put her on the phone.
[AGENT][POSITIVE] I'll be happy to
[CUSTOMER][POSITIVE] Oh yeah, yeah, that's perfect. I didn't know if you want to do that. That's cool, yeah, you can do that.
[AGENT][NEUTRAL] And what is her name?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hi, this is [PII]. How are you today?
[CUSTOMER][POSITIVE] I'm good, thank you. How are you?
[AGENT][NEUTRAL] I'm doing fine, thank you. So Mr. [PII] said that you're with the provider's office, is that correct?
[CUSTOMER][NEUTRAL] Did
[CUSTOMER][NEUTRAL] Correct. My name is [PII] and I'm with Peak Dental.
[AGENT][NEUTRAL] OK, [PII], and he was stating that you were needing to verify eligibility and benefits for him?
[CUSTOMER][NEUTRAL] Well, yes, because he walked in and asked if we take APL and I've never heard of it, so he got on the phone with you guys.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So the policy that he had, well, first off, any information, [PII], that I do provide would be a verification of benefits and not a guarantee of payment. But this general plan that he has, it is not a network plan. It is not a PPO or anything like that. They may select any provider they're choosing to go to, and benefits of coverage services are based on a percentage of the UCR of the service region.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I was sitting.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oops, percentage.
[AGENT][NEUTRAL] Mhm. And I have a fax.
[CUSTOMER][NEUTRAL] So it's a discount plan? Is, is that what it is?
[AGENT][NEUTRAL] Well, again, it's based on a percentage of the usual and customary rates within the service region.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, the fact that has all of his benefit information on there.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and anything, any code that's not on the fax back means it would not be covered under his plan.
[CUSTOMER][NEUTRAL] Then maybe [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] But I'll be happy to send you a copy of that if you would like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yes, please.
[AGENT][NEUTRAL] All right, so give me just a moment and just while that's loading, we do not have any history on file for him.
[CUSTOMER][POSITIVE] So thanks for calling.
[CUSTOMER][NEUTRAL] OK. No history. And I'm sorry, and your name again was [PII]. OK. Thank you, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh. And well, the fax, you're welcome, [PII], and go ahead and give me your callback number as well.
[CUSTOMER][NEUTRAL] you know
[CUSTOMER][NEUTRAL] Our fax our callback number is [PII]. You're welcome bye [PII].
[AGENT][NEUTRAL] OK, thank you. And go ahead and give me your fax number.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Now, do you, does the fact need to have be put to your attention or is that not necessary?
[CUSTOMER][NEUTRAL] My first thought was like somebody he know his name I'm like.
[CUSTOMER][NEUTRAL] No, that's not necessary. It's fine. It comes and then I'll give it to the insurance coordinator. I [PII] and as [PII] #2 and yeah, and then [PII] and [PII] like on my healthcare ID.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so one moment.
[AGENT][NEUTRAL] And again, that fax number was [PII].
[AGENT][NEUTRAL] OK, so I have just sent that over so provided there's not any type of technical mishap, you should be receiving that very shortly.
[CUSTOMER][NEUTRAL] OK perfect perfect and then you said it pays a percentage of of of basically our fee schedule is what it's gonna do, correct? OK, OK, ACR OK so those are our fees. OK, OK, perfect, [PII] and um, can I, do you have a reference number by chance?
[AGENT][NEUTRAL] Alright, [PII].
[AGENT][NEUTRAL] That's a percentage of the UCR of the service region, the covered services.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, fine.
[AGENT][NEUTRAL] You would use my name along with today's date.
[CUSTOMER][POSITIVE] OK, perfect. I will wait for the facts. I appreciate it thank you. Um, I'll hand him back the phone because it's his phone, so here you go. She just wants to know if you have any other questions. Oh, OK, no, that's all thank you.
[AGENT][NEUTRAL] OK. All right. Well, it has to see you're certainly welcome. And do you want to ask, um, Mr. [PII] if he has any other questions for me before we hang up?
[AGENT][POSITIVE] OK. OK. All right. Thank you.
[AGENT][POSITIVE] OK, Mr. [PII]. Well, I'll be sending you this email that I was talking about. You should have that within just the next few minutes. And again, is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] People it is their first and last name and then usually whatever they're from like if they're from stuff No, that's all.
[AGENT][POSITIVE] OK, well then thank you for calling APL and I hope you have a nice rest of your day.
[CUSTOMER][NEUTRAL] I feel like
[CUSTOMER][NEUTRAL] Alright, you too.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] And I.