AccountId: 011433970860
ContactId: 94a04a10-9e73-4af8-a9de-47ebb0a960fe
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 276619 ms
Total Talk Time (AGENT): 140595 ms
Total Talk Time (CUSTOMER): 98350 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/94a04a10-9e73-4af8-a9de-47ebb0a960fe_20250313T14:41_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] If anything is change you can change.
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I am calling from Clifton Dental Care. Um, I just need to get a breakdown of benefits and see if we are in network with your insurance company.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you with that breakdown of benefits and eligibility too. What is a good callback number?
[CUSTOMER][NEUTRAL] It is gonna be area code [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. I'm sorry, [PII], and what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Um, give me just a second, shoot, hold on, I don't know why I'm not able to pull it. Oh, here it is. OK, um, it is gonna be.
[CUSTOMER][NEUTRAL] 025.
[CUSTOMER][NEUTRAL] 74076.
[AGENT][POSITIVE] Oh goodness.
[AGENT][NEUTRAL] Do you mind repeating that? I do apologize.
[CUSTOMER][NEUTRAL] Oh no you're fine it's 02574076.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] What is the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] Uh name is gonna be [PII]. Date of birth is gonna be do do do do do do do do do do. Oh, hold on, I have it written down. um [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Let's see. I can help you with that eligibility and breakdown. I'm showing that coffee, coffee, coffee, I'm sorry, that one caught me off guard.
[AGENT][NEUTRAL] Like I need another cup of that. I'm sorry. OK, um.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] showing that this policy is active. Effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] As far as network, the policy does participate in the Carrington PPO network, but network participation is not required.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And I do have a breakdown I can fax to you that does have the calendar year max deductibles, frequencies, limitations, our billing information and the procedures listed that are covered, and I'll be happy to fax that to you.
[CUSTOMER][POSITIVE] Oh that would be great. um, does he have any like history or anything that would be included in on that?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] He actually has no history.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the group name and number is not gonna be included as well, which I can provide if needed.
[CUSTOMER][POSITIVE] Yeah yeah that would be great.
[AGENT][POSITIVE] Alright, let me get that for you.
[AGENT][NEUTRAL] The group number is 70056.
[AGENT][NEUTRAL] And the group name is management.
[AGENT][NEUTRAL] Analysis.
[AGENT][NEUTRAL] And utilization.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And I will tell you this policy is a limited dental policy. It does not cover major procedures.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and then, uh, like major, is that just like crowns, bridges, and prosthetics, or do you consider major like, um, I know Imperial also.
[AGENT][NEUTRAL] Oral surgery, prosthodontic repairs, or uh endo and periodontic services.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][POSITIVE] OK awesome.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] We do coordinate benefits as standard.
[AGENT][NEGATIVE] There is a missing tooth cloth that is listed on the breakdown as well.
[CUSTOMER][NEUTRAL] All right great yeah um you said you could fax that over?
[AGENT][NEUTRAL] And what's the fax number?
[AGENT][NEUTRAL] Yes, ma'am. I've got that ready to fax to you. What's that number?
[CUSTOMER][NEUTRAL] It is gonna be 513.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, and just to verify that fax number, I'm sending this to [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] I just hit send. You should be receiving that shortly, and [PII], it was a pleasure to assist you with that breakdown in network information. Is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] No, you are good thank you so much for your help I appreciate it.
[AGENT][POSITIVE] And thank you for calling APL. It's been a pleasure to assist you and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] You too thanks so much.
[AGENT][POSITIVE] Thank you.