AccountId: 011433970860
ContactId: a5bbca22-1e94-4c8b-ad95-af2dd71dd4b8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 287390 ms
Total Talk Time (AGENT): 127057 ms
Total Talk Time (CUSTOMER): 133440 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/a5bbca22-1e94-4c8b-ad95-af2dd71dd4b8_20250121T21:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Oh wow um hi my name is [PII] as well.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Hi
[AGENT][NEUTRAL] How are you?
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][POSITIVE] I'm good. I'm good, thank you.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Alright, um, sorry about that. I just have a question. A patient just sent me an insurance card and I just want to see if I, uh, if she's eligible at our office.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] OK, and [PII], before we get started, what is your callback number if we are disconnected please?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] Thank you so much and what is the policy number please?
[CUSTOMER][NEUTRAL] Uh, yes, the policy number is going to be 02571860.
[AGENT][NEUTRAL] OK, thank you, let me just repeat that to you. I have that as 02571860.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] Thank you, thank you so much and verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Um, patient's name is gonna be [PII], last name [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you so much for the verification process. Um, she shows effective as of [PII], so the policy is active and in regards to network participation, uh, the plan does participate in the Carrington PPO network. If your doctor or the dentist is not a participating provider, it will then follow UCR.
[AGENT][NEUTRAL] We still pay the provider based on what's covered of course.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and then I am going to do you have a possibility of able to send like an email or a fax of the patients like benefit breakdown?
[AGENT][NEUTRAL] Of course we can fax it over to you and what is your fax number please?
[CUSTOMER][NEUTRAL] Yes [PII].
[CUSTOMER][NEUTRAL] 896 0 no no no no no sorry 615-8448.
[AGENT][NEUTRAL] No, no, I'm sorry, OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so let me just repeat that to confirm I have that as [PII].
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] OK, yes, I can get that sent over to you via fax. Um, now I will tell you that it does not cover any major services and with major that includes oral surgery, any perio is not covered and adontics is also not covered under this policy.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And then um what is the percentage coverages for preventative, diagnostic and basic?
[AGENT][NEUTRAL] OK, for preventative it's covered at 100% and basic is covered at 80%.
[CUSTOMER][MIXED] OK, but major is not covered at all.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] Alright, oh,
[CUSTOMER][NEUTRAL] Actually, not that I actually yeah, periodontics.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, right, I think that's all that I need, uh, after, yeah, I think that's all that I need.
[AGENT][NEUTRAL] OK, and she has no history at all on file and I'll get that sent over to you.
[CUSTOMER][NEUTRAL] OK, thank you. Oh, and then one more thing, um, these are procedure codes are the pro these procedure codes on the benefit breakdown that you're gonna be sending to me?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Well, procedure codes will be on the, yes, the bear down that I'll send over to you, but if you want me to check something real quick for you, I can.
[CUSTOMER][NEUTRAL] OK, um, it's just for 00431.
[CUSTOMER][NEUTRAL] D 9944 and D 4381 sorry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, no problem, no problem, and those are not covered on this policy.
[CUSTOMER][MIXED] Not covered awesome thank you.
[AGENT][POSITIVE] You're welcome, and I'll get that faxed over to you and thank you for calling AP Angel. You have a great day.
[CUSTOMER][NEUTRAL] OK, oh wait, can I have a reference number?
[AGENT][NEUTRAL] Oh yeah, oh sorry, we do not provide reference numbers, but please use my name. My last initials [PII], and today's date please.
[CUSTOMER][NEUTRAL] Hey, my last name initial is [PII]
[AGENT][NEUTRAL] OK, I was about to say my goodness, OK.
[CUSTOMER][POSITIVE] Sorry, sorry, OK, have a wonderful day thank you.
[AGENT][POSITIVE] You're welcome you too thank you bye bye.
[CUSTOMER][NEUTRAL] Bye bye.