AccountId: 011433970860
ContactId: 8db470ef-73df-4137-b243-8dc5b72f7aaf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 252279 ms
Total Talk Time (AGENT): 119269 ms
Total Talk Time (CUSTOMER): 81070 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/8db470ef-73df-4137-b243-8dc5b72f7aaf_20250305T15:34_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] Good morning. My name is [PII]. Um, I work at Revital Demo. I'm just calling to see if we're in network with this insurance.
[CUSTOMER][NEUTRAL] Or if we take
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can take a look and see what type of, oh, go ahead.
[CUSTOMER][NEUTRAL] I had a patient
[CUSTOMER][NEUTRAL] I had a patient call this morning and I'm, I haven't, I know we take most of the normal Blue Cross like Cigna. I haven't heard of this one, so I was just calling to see if we would network with this insurance or not.
[AGENT][NEUTRAL] OK. Um, well, I can definitely help you with the coverage in the network. And may I have a good contact number in case we're disconnected and then um the policy number?
[CUSTOMER][NEUTRAL] Yeah it's [PII], uh, policy number.
[CUSTOMER][NEUTRAL] Um, it's 02558125.
[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] It's [PII], uh, 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. Um, so I am showing the policy is active. It's been effective since [PII]. And let me see what type of policy. Hold on one moment.
[AGENT][NEUTRAL] So this policy is not on a network, um, so,
[AGENT][NEUTRAL] Network in terms of like PPO with the list of providers or it doesn't have a network, it is on the Carrington fee schedule?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Carrington fee you said?
[AGENT][NEUTRAL] Mhm. This is um Carrington sea schedule.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But there's no network with like a list of providers. There's no in or out of network benefits, the benefits are the same.
[CUSTOMER][NEUTRAL] OK, so it's more like a um.
[CUSTOMER][NEUTRAL] Like a health plan card kind of thing or how does that work?
[AGENT][NEUTRAL] This could be like a secondary insurance if there's no other dental insurance like with their primary, um, this could be their primary insurance, but it does have like a calendar year max and deductible. Um, it covers preventative, basic and major expenses. Um, it's just not like a PPO or HMO policy to where it has a list of providers.
[CUSTOMER][NEUTRAL] OK, OK, that's what I'm wondering, um, OK, um.
[CUSTOMER][NEUTRAL] OK, um, is there a way you can like, um, I guess email me or something with like I guess the percentages?
[AGENT][NEUTRAL] Yeah, um, I can fax you a copy of the fax back. On the fax back, you'll see the calendar year, um, maximum deductible. You'll see all the percentages, waiting periods, any frequencies, um, all the ways to file a claim and then there's a list of covered codes. If the code you're looking for isn't on that list, then it wouldn't be covered by the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] And what's a good fax number for you?
[CUSTOMER][NEUTRAL] It's 2 by 4.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And um should I put attention [PII]?
[CUSTOMER][NEUTRAL] Yeah, you can or you can um.
[CUSTOMER][NEUTRAL] You just put um it doesn't matter.
[AGENT][NEUTRAL] Alright, and it was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, so I'll go ahead and fax this over to you now. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Uh, no, that should be it.
[AGENT][POSITIVE] Alright well thank you for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you, bye bye.