AccountId: 011433970860
ContactId: a1bf5962-d751-4d63-8357-cc539065e5d4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251000 ms
Total Talk Time (AGENT): 128705 ms
Total Talk Time (CUSTOMER): 71325 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/a1bf5962-d751-4d63-8357-cc539065e5d4_20250416T17:26_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from Dental 365. A patient of ours was recently switched to your insurance plan. I just want to confirm eligibility and get some information about it, please.
[AGENT][NEUTRAL] OK, [PII], uh, so you need eligibility on a dental policy. Do you also need a fax back of benefits? Yes, ma'am, I can help you with those things. And what is a good call back number for you please?
[CUSTOMER][POSITIVE] Yes please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number please [PII]?
[CUSTOMER][NEUTRAL] Yes, 02587092.
[AGENT][NEUTRAL] The last number was a 2, is that correct?
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Give me just a couple moments to get the member's information pulled up please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, [PII], any information that I do provide today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth, please?
[CUSTOMER][NEUTRAL] Yes, it's [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show that you're the subscriber on this dental policy and it is active, effective [PII].
[AGENT][NEUTRAL] And we do not have any history on file for December.
[CUSTOMER][NEUTRAL] And what exactly is the name of her dental plan that she has?
[AGENT][NEUTRAL] American Public Life.
[CUSTOMER][NEUTRAL] And is it a PPO plan?
[AGENT][NEGATIVE] RIP.
[AGENT][NEUTRAL] This plan participates in the Carrington PPO network. however, they are not required to utilize the network provider.
[CUSTOMER][NEUTRAL] So if we're out of network, how does that work? Do they pay off a set fee schedule?
[AGENT][NEUTRAL] It, it goes by the Carrington fee schedule, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, but we're not um contracted with Carrington, so it'd be a regular office fees, so she would have to pay the difference.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, we don't determine patient responsibility. That would be up to the provider.
[CUSTOMER][NEUTRAL] OK, um, and can you fax over the breakdown of benefits please?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Uh, sure, yes ma'am. And what's a good fax number for you, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm just gonna repeat that back to you. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and does it need to be put to your attention or is that not necessary?
[CUSTOMER][NEUTRAL] No, it goes right to our email. Yeah, that's OK.
[AGENT][NEUTRAL] Oh, OK, OK, well, I have just sent that to you so provided there's not any type of technical glitch, you should be receiving that within just the next uh few minutes. And then if you all end up filing a claim with us, [PII], once the claim has been processed by APO there we do have a portal in which you should be able to check claim status and that portal website is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, and can I have a reference number for the call, please? Mhm.
[AGENT][NEUTRAL] Yes ma'am, secure. [PII]. Sure, you would use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] Oh perfect OK.
[AGENT][NEUTRAL] All right. And is there anything?
[CUSTOMER][POSITIVE] All right, thank you so much for your help and uh uh no, and the ID number I gave you is the one that I would use, correct?
[AGENT][POSITIVE] Well, you're welcome.
[AGENT][NEUTRAL] Yes, ma'am, it is. That is the valid ID number. Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you so much for your help. You have a great day.
[AGENT][POSITIVE] Well, I hope you have a great day too, and thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] All right, [PII], bye bye.