AccountId: 011433970860
ContactId: 7e80d983-2851-425a-8534-4d77d8ceb6c5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249149 ms
Total Talk Time (AGENT): 123146 ms
Total Talk Time (CUSTOMER): 62702 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/7e80d983-2851-425a-8534-4d77d8ceb6c5_20250212T14:00_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I'm calling from a dental office. I needed to get dental benefits please.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the dental benefits. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and a good contact number is [PII] and it's no um extension.
[AGENT][NEUTRAL] Alright and may I have the member's policy number?
[CUSTOMER][NEUTRAL] Um, it is 02484355.
[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] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. I am showing the policy is active. It's been effective since [PII], and hold on one moment, let me see what type of plan he has.
[AGENT][NEUTRAL] OK. So it's coming up now. Hold on one moment. So did you have particular questions about the fax back or you just needed a copy of it or you have particular questions?
[CUSTOMER][NEUTRAL] Um, if you can send me a fax, but she's actually here, so I needed it over the phone, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure. Um, so the calendar year max is $750 per insured.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] There is a $50 deductible.
[AGENT][NEUTRAL] That does not apply to preventative services.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, preventative is covered at 100%. Radiograph and FMX, basic expenses and basic restorative are all covered at 80%.
[AGENT][NEUTRAL] There's no major coverage, um, which includes for us endodontic, periodontic, prosodontic, and oral surgery.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, proffe are once every 6 months.
[AGENT][NEUTRAL] Oral evaluations are 2 for 12 month period.
[AGENT][NEUTRAL] Fight wings are once per 12-month period.
[CUSTOMER][NEUTRAL] Are fillings covered under basic?
[AGENT][NEUTRAL] Uh, let me see.
[AGENT][NEUTRAL] Do you have a code for the fillings?
[CUSTOMER][NEUTRAL] Uh, you can try the 2392.
[AGENT][NEUTRAL] Yes, basic restorative at 80%.
[CUSTOMER][NEUTRAL] OK, is there a missing case call?
[AGENT][NEUTRAL] Uh, let me see. This policy does have a missing tooth cloth.
[CUSTOMER][NEUTRAL] OK, and then is there any waiting period on the basics?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] And then what's the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] And then what the schedule do you go by?
[AGENT][NEUTRAL] This is on the Carrington PPO network. Um, however, if your provider is not a Carrington provider, the benefits are still the same.
[CUSTOMER][NEUTRAL] OK, and is there a Carrington fee schedule or do you go by like in the max?
[AGENT][NEUTRAL] Yeah, it's just a standard standard fee schedule.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right thank you ma'am.
[AGENT][NEUTRAL] You're welcome. And then [PII], did you um want me to send this over to you in a fax?
[CUSTOMER][POSITIVE] Yes, ma'am, that would be great.
[AGENT][NEUTRAL] OK, what's your fax number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And put attention [PII].
[CUSTOMER][POSITIVE] Yes, ma'am, that'll be fine.
[AGENT][NEUTRAL] OK, and that was [PII]?
[CUSTOMER][NEUTRAL] Right, yes, ma'am.
[AGENT][POSITIVE] All right, I'll go ahead and send this over to you now. Was there anything else I can help with?
[CUSTOMER][NEUTRAL] Uh, no, ma'am, that's all.
[AGENT][POSITIVE] Alright well thanks for calling APL have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you. Bye bye.