AccountId: 011433970860
ContactId: 8586a0da-d3ee-43d2-9fc7-7d506c9acaf5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 460679 ms
Total Talk Time (AGENT): 177951 ms
Total Talk Time (CUSTOMER): 97343 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/8586a0da-d3ee-43d2-9fc7-7d506c9acaf5_20250206T21:46_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL this is [PII] how may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from Aspen Dental, and I'm just looking for a breakdown of dental benefits on a patient.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hi, can you hear me?
[CUSTOMER][NEUTRAL] I can hear you.
[AGENT][NEUTRAL] OK, good. I'm so sorry, the phone cut out for a minute. OK. And did you say your name was [PII] with Aspen Dental, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK Miss [PII], I can help you with benefits on a patient. I did hear that much. Um, what is your call back just in case our call is disconnected.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, um, my callback number is [PII] option 2.
[AGENT][POSITIVE] OK. Thank you so much. And then what is the patient's name?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then what is [PII]'s policy number?
[CUSTOMER][NEUTRAL] Um, so it says it's D as in dog 47694548.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK, let me see if I can find him in our system by his name.
[CUSTOMER][NEUTRAL] OK, yeah, he only had one card, so I it.
[CUSTOMER][POSITIVE] I could give you a social if that helps.
[AGENT][POSITIVE] Yes absolutely yes ma'am thank you.
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let me look it up that way.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And we're looking for his dental policy. So, I think I have it right here.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] And it does match his birthday.
[AGENT][NEUTRAL] OK. I believe I have him pulled up. Um, his policy number is 2586592.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect and what's is there a group number?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes ma'am, the group number is 70084.
[AGENT][NEUTRAL] And that's Serge Staffing.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then his effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you give me your fax number, I can send you a fax back with this benefit breakdown for you.
[CUSTOMER][NEUTRAL] OK, um, is it pretty quick when it like with when you put it in?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Like, does it come through pretty OK, good. OK, it is 864.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I get that fax. I'm gonna send it while we're on the phone together.
[CUSTOMER][POSITIVE] Awesome. Thank you.
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] SB High.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, uh Miss [PII], I've got that fax on its way to you now.
[CUSTOMER][NEUTRAL] OK, and then really quick um just one quick question, what is the claims address that we'll file claims to?
[AGENT][NEUTRAL] Yes ma'am, the claims address is APL Claims [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Alright, and then is what network would I be using?
[AGENT][NEUTRAL] Um, it's, uh, going to be percentage of UCR.
[AGENT][NEUTRAL] And because it's with benefits on a card, it'll be through Carrington.
[CUSTOMER][NEUTRAL] Carrington, so it's a PPO plan?
[AGENT][NEUTRAL] Uh, no, ma'am. The, the pay, the fee schedule is through UCR, usual customary reasonable.
[CUSTOMER][NEUTRAL] OK, so is it like an indemnity plan?
[AGENT][NEUTRAL] No, ma'am. Um, it's a regular dental plan. Like his, um, the way that his fax back is broke down is like his preventative expenses, and this is just to verify coverage, it's not a guarantee of payment. He has 100% of allowable and the allowable will be UCR.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All the dental comes through us.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, but we do participate in the Carrington PPO network, but it says, however, utilization of a provider within the Carrington network is not required.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Well, that.
[CUSTOMER][NEUTRAL] And then no, then that should be all I need.
[AGENT][POSITIVE] OK, alright, Ms. [PII], um, that fax should be getting there any minute now and we appreciate you calling APL today and I hope you have a great rest of your night.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Alright thanks you too bye bye.
[AGENT][POSITIVE] Thank you, ma'am.