AccountId: 011433970860
ContactId: a34da6e2-21cf-49e7-84d5-5d4d2657646e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 452209 ms
Total Talk Time (AGENT): 103745 ms
Total Talk Time (CUSTOMER): 143151 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/a34da6e2-21cf-49e7-84d5-5d4d2657646e_20250501T14:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII]. I'm calling from Park Place Dental, and I'm trying to get a breakdown of benefits for a patient, please.
[AGENT][POSITIVE] Hi [PII], I can help you with benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And the patient's policy number?
[CUSTOMER][NEUTRAL] Um, the ID is 42348531.
[AGENT][NEUTRAL] Policy number of ours. Um, do you have the last name?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][POSITIVE] [PII]
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And first thing.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] I'm trying to locate a policy under that name.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, the printout on the card, she gave me, the policy is 02064557, but when I called.
[CUSTOMER][NEUTRAL] Um, the other people, they gave me her ID number and told me to call you guys for the breakdown.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, yeah, the [PII] is the right number. And what was her birthday again?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Her birth date is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] So is that.
[CUSTOMER][NEUTRAL] That would that be considered the group number?
[AGENT][NEUTRAL] No, her policy number is 20.
[CUSTOMER][NEUTRAL] Or do I need to
[AGENT][NEUTRAL] 206-455-557.
[CUSTOMER][NEUTRAL] OK, now do I need to use that as her ID number or the ID number he gave me?
[AGENT][NEUTRAL] No, that'll be her policy ID number. Yeah, the ID number is 206-45557.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then for the benefits that show effective [PII], um, I can send a fax back that has all the benefits listed, or if you need to go over some certain things on the phone, I can help you with that.
[CUSTOMER][NEUTRAL] OK, yeah, you can do the fax back and then I'll just ask you a couple questions if that's OK.
[AGENT][NEUTRAL] Sure. Uh, what's that fax number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and then anything I quote today is not a guarantee of payment. It's a basic outline of the policy. And then how can I help?
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] I know it says Carrington Solutions. Um, is that a Aetna fee schedule or no?
[AGENT][NEUTRAL] Um, Carrington is the PPO network they can utilize, so.
[AGENT][NEUTRAL] Um, if you're a Carrington provider, then there'll be a discount involved with the bill charges.
[CUSTOMER][NEUTRAL] OK, I don't think, yeah, we're not, um, OK, um, let's see, are implants covered?
[AGENT][NEGATIVE] No, they're not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there a missing tooth cloth?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you give me uh any preventative history that she has recently?
[AGENT][NEUTRAL] Uh, sure, let me look that up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, looks like the last preventative was in [PII], so she's eligible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, even for uh pano.
[AGENT][NEUTRAL] Um, pano actually falls under 80%. It's subject to a $50 deductible.
[AGENT][NEUTRAL] Um, let me look at pano.
[AGENT][NEUTRAL] Is that 3330 or what what's the code?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That's it 3330.
[AGENT][NEUTRAL] Don't have that on file.
[CUSTOMER][NEUTRAL] OK, no history.
[CUSTOMER][NEUTRAL] And you said it's only covered at 80%?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm not seeing the facts come yet, so I'm gonna ask you a few more so I can get it put in. OK, so, um, is all other preventative at 100%?
[AGENT][NEUTRAL] Uh, just cleanings and propies. I hadn't sent the facts yet. I usually do it when I get off the phone, yeah.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] What about basic coverage?
[AGENT][NEUTRAL] It pays 80% after a $50 deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And major 50.
[AGENT][NEGATIVE] There's no major coverage.
[CUSTOMER][NEGATIVE] No major coverage.
[CUSTOMER][NEUTRAL] OK, so is, um, endo Imperio is that considered under basic or major?
[AGENT][NEUTRAL] Major.
[CUSTOMER][NEUTRAL] OK, so no major coverage, OK.
[CUSTOMER][NEUTRAL] OK, alright, well, um, I'll wait on the fax then thank you.
[AGENT][POSITIVE] OK, thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.