AccountId: 011433970860
ContactId: 985efdb3-a6d1-422c-816b-521fbe5c8619
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 426119 ms
Total Talk Time (AGENT): 185432 ms
Total Talk Time (CUSTOMER): 191684 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/985efdb3-a6d1-422c-816b-521fbe5c8619_20250429T19:36_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII]. I'm calling from Lyman Family Dentistry. How are you?
[AGENT][POSITIVE] I'm doing well. How are you?
[CUSTOMER][POSITIVE] I'm good thank you. I was just calling to find some find out some eligibility without a patient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the eligibility and [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes ma'am, contact number is area code [PII].
[CUSTOMER][NEUTRAL] And the policy number is 02609253.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][POSITIVE] Yes, and thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, ma'am, it's first name is [PII], last name is [PII]. 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. And I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I have another silly question. Does he work um the group that he works with, can you provide that information for me?
[AGENT][NEUTRAL] Yes, um, hold on one moment.
[CUSTOMER][POSITIVE] You're good. You can have a seat. It'll be out in just a moment.
[AGENT][NEUTRAL] The group number is 70056.
[AGENT][NEUTRAL] The group name is management.
[CUSTOMER][NEUTRAL] And yep.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] No, go ahead, I'm sorry.
[AGENT][NEUTRAL] No, it's OK. Um, the group name is Management, analysis and Utilization or MUA.
[CUSTOMER][NEUTRAL] OK, I have another silly question. We have other patients in this practice that work at MAU and they have a totally different insurance.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I'm I'm just a little confused because like one of them was just here at the beginning of April and his other insurance.
[CUSTOMER][NEUTRAL] Was active at that time so can do they did they switch in the middle of the month?
[CUSTOMER][NEUTRAL] If you can see that information.
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Because MUA has been with us for years, or at least 2. I've been here 2 years.
[CUSTOMER][POSITIVE] I was right.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Because they're also with Cigna.
[CUSTOMER][NEGATIVE] And that's why I'm confused and I kept telling her I feel bad. I kept telling her like.
[AGENT][NEUTRAL] Well, Cigna
[CUSTOMER][NEUTRAL] I know it's signa because he was just here.
[AGENT][NEUTRAL] Wait, but Cigna is for their medical policy. Now Cigna, the Cigna policy may have dental coverage, but that's different than this dental policy.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Right, so the other employees that have just been here like I said this month, they have, I mean the Cigna is the dental.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Oh, so they, they just didn't elect for this policy.
[CUSTOMER][NEUTRAL] As well.
[CUSTOMER][NEUTRAL] OK, so MAU has different insurance companies attached to them?
[AGENT][NEUTRAL] No, so Cigna is a medical insurance. The medical insurance could also offer dental if they choose to keep their medical insurance with whatever dental coverage they have, that's their dental policy.
[CUSTOMER][NEUTRAL] Well, Cigna is also dental. Cigna is not just medical, they're also dental insurance.
[AGENT][NEUTRAL] Right, which is why I said they can also have dental coverage. Cigna is a primarily a medical insurance company that can have dental coverage. So if the patient then does not decide to have the APL policy and just keep the Cigna, that I don't know what coverage is on that policy.
[AGENT][NEUTRAL] But this is just a total dental policy.
[CUSTOMER][NEUTRAL] OK, OK, because they're.
[CUSTOMER][NEUTRAL] OK, I guess I'm just a little confused because Cigna is not mainly just a medical like not even just with MAU across the board. I mean it's a Medicare dental policy like there's, it's not just a medical it's not just like a medical with a dental that you can get they have their own dental coverage as well.
[AGENT][NEUTRAL] That's exactly what I just said. So, you can just like you can have a primary, secondary criteria, you can have multiple dental policies. If they didn't elect to have their APL and they just want Cigna, that's their choice. So there.
[AGENT][NEUTRAL] You can have multiple, that's why we don't have a coordination of benefits for our dental policies, because however it comes in, we're gonna process it whether you give it to Cigna first, a second, whoever, you can have multiple policies.
[CUSTOMER][NEUTRAL] OK, and that, but that's what that was my question was with the MAU do you guys have different so like say I am signing up when I sign up for insurance if I have Cigna.
[CUSTOMER][NEUTRAL] I have Cigna Medical Dental and Vision, and that's how that works, whereas like you can get just a separate dental policy through.
[CUSTOMER][NEUTRAL] You guys
[AGENT][NEUTRAL] So they can elect to have their their Cigna policy if that policy has dental, they'll have dental for Cigna and if they elect to have an APL dental policy with Carrington, they can have that also.
[CUSTOMER][NEUTRAL] OK, that was my question.
[AGENT][NEUTRAL] It comes through the employer and then the employer sends it to us, so I don't know how they're pitching it to their people, but they can have more than one.
[CUSTOMER][NEUTRAL] Yes ma'am, no, I, I mean I don't know how they're pitching it either, but I was just asking because in when you put in dental insurance you have to list it under the employer, so I was just trying to figure out how we were gonna do that. That's that's why I was trying to understand.
[AGENT][NEUTRAL] Right, well, yes, you can, they can have multiple and you can build multiple and we don't have a coordination of benefit on ours so it'll process.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] OK perfect yeah that's what I was asking. I apologize.
[AGENT][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] I've just never this is the first patient we've had that has worked at MAU that has had this insurance so I was just trying to figure out so I could put it in my system correctly.
[AGENT][NEUTRAL] I understand. Well, was there anything else I could assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Um, no, ma'am, I just will wait for that fax back.
[AGENT][NEUTRAL] All right, and what is the um good fax number for you?
[CUSTOMER][NEUTRAL] It's area code [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, do I need to put attention in [PII]?
[CUSTOMER][NEUTRAL] Um, no, I'm the only one up here.
[AGENT][NEUTRAL] Alright, and it's [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Alright, so I'll go ahead and fax this over to you now, OK?
[CUSTOMER][POSITIVE] Awesome thank you so much.
[AGENT][POSITIVE] You're very welcome. Was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] Nope, I think we're good. You helped me more than you needed to.
[AGENT][POSITIVE] Alright, [PII], well, thanks so much for calling APL. I hope you have a good evening.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.