AccountId: 011433970860
ContactId: 9a603995-76fe-4b49-9304-31c17013fe36
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 340070 ms
Total Talk Time (AGENT): 106889 ms
Total Talk Time (CUSTOMER): 105289 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/9a603995-76fe-4b49-9304-31c17013fe36_20250527T14:43_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from, uh, Matlock Family Dental provider's office, and I just wanted to see if you can assist me with finding out if, um, um, a patient here is, um, trying to use your guys' insurance, um, so I got the number on the back of her card, wanted to see if we are credential of the network, um, if it's a PPO, just a few eligibility benefits.
[AGENT][NEUTRAL] OK, I can help you with the eligibility and benefits. [PII], do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] Her policy number is going to be 02609826.
[AGENT][NEUTRAL] And what is the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] OK, so the policy is active and effective [PII]. I can send over a fax back that outlines all of the benefits. Um, the network is Carrington.
[AGENT][NEUTRAL] Uh, I don't have access to who's in network with Carrington. I can also give you that number if you'd like to check.
[CUSTOMER][NEUTRAL] OK, what's that number?
[AGENT][NEUTRAL] Harrington is
[AGENT][NEUTRAL] And all they can do is just strictly tell you if you're in or out of network, um, get that.
[AGENT][NEUTRAL] Uh, [PII]'s [PII].
[AGENT][NEUTRAL] And then would you like me to fax over uh the outline of all the benefits?
[CUSTOMER][POSITIVE] I would, yes.
[AGENT][NEUTRAL] Um, what is your fax number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'll get that faxed over. It just takes a few minutes. Um, is there anything else I can help with?
[CUSTOMER][NEUTRAL] Uh, yes, um, I just wanted to verify then the mailing address, uh, for claims.
[AGENT][NEUTRAL] Our mailing address is [PII].
[CUSTOMER][NEUTRAL] OK, and then you guys just pay your ID.
[AGENT][NEUTRAL] Your ID is 60801.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Alrighty, uh, thank you so much. Oh, actually, um, is there any way that you can answer a few, um, benefit details?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, so because I have here a few things that are sometimes not on the fax back, so, um, does she have any history of missing tooth cost?
[AGENT][NEUTRAL] Uh, she has no history, and there is a missing two clause. Actually, let me see, there is some.
[AGENT][NEUTRAL] Uh, it looks like she has
[AGENT][NEUTRAL] Uh, she's already had a cleaning.
[AGENT][NEUTRAL] And bite wings, [PII].
[AGENT][NEUTRAL] And let me see.
[AGENT][NEUTRAL] Yeah, it looks like.
[AGENT][NEUTRAL] This is not a guarantee of payment based outline of the policy. So she has a $500 calendar year maximum, and it looks like that actually was exhausted on [PII].
[CUSTOMER][NEUTRAL] So it was just for a profi and bite week.
[AGENT][NEUTRAL] Uh, she had other services as well.
[CUSTOMER][NEUTRAL] Or was it the whole thing?
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, and then the annual max is 500.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, you said missing because the supply.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, any waiting periods?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Um, our Cuzo cards covered 9945 or 9946?
[AGENT][NEGATIVE] No, they're not.
[CUSTOMER][NEUTRAL] And what about for deep cleanings, um, how many quadrants could we perform on day 2 or 4?
[AGENT][NEGATIVE] It's not covered under the policy.
[CUSTOMER][NEGATIVE] Not covered um
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][POSITIVE] Alright, thank you so much. That was all the information that I needed. I look forward to the fax.
[AGENT][POSITIVE] OK, well, thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too.