AccountId: 011433970860
ContactId: a5edb174-60c8-4de9-8ccb-07650532b112
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 256399 ms
Total Talk Time (AGENT): 117802 ms
Total Talk Time (CUSTOMER): 82616 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/a5edb174-60c8-4de9-8ccb-07650532b112_20250206T18:21_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] Uh, hi, uh, good afternoon, [PII] here calling on behalf of the dental group checking for patients eligibility and benefits.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the eligibility and benefits, [PII]. May I have a good contact number in case we're disconnected and the member's policy number?
[CUSTOMER][NEUTRAL] Uh, sure. The contact number is, it's [PII] and the ID is 02558867.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, sure. The member 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. So the dental policy number is actually 255.
[AGENT][NEUTRAL] 886 8.
[CUSTOMER][NEUTRAL] OK, so there's no 0.
[CUSTOMER][NEUTRAL] At the beginning.
[AGENT][NEUTRAL] Well, not just that, but you said 67, that's their hospital indemnity policy. This policy ends with an 8.
[CUSTOMER][NEUTRAL] Oh, so it's uh 25588.
[AGENT][NEUTRAL] 2558868.
[CUSTOMER][POSITIVE] OK, 66. OK. Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] So, um, hold on one moment, I'm pulling up that policy now, and the policy has been active since [PII]. And did you need a copy of the fax back or you have particular questions about the fax back?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, well, uh,
[CUSTOMER][NEUTRAL] I don't have the uh fax back with me, so uh I would like to request one for dental.
[AGENT][NEUTRAL] Sure, and what's a good fax number for me to send it to?
[CUSTOMER][NEUTRAL] At [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And should I put attention, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I, on the fax back you'll see the calendar year max, the deductible, all the percentages, any frequencies, exclusions, all three ways to file a claim and the information, and then there's a list of covered codes. If the code you're looking for is not on this list, it wouldn't be covered by the policy. Did you have additional questions?
[CUSTOMER][NEUTRAL] Uh yes, uh, which fee schedule the provider would use?
[AGENT][NEUTRAL] Um, this is on the Carrington PPO network. However, if your provider is not a Carrington provider, um, the benefits are still the same. Those are standard Carrington fee schedule.
[CUSTOMER][NEUTRAL] OK. And uh also the used amount and the history would be included on the facts?
[AGENT][NEUTRAL] Um, hold on one second. The fax box just popped up. Hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so I just faxed it over to you and then let me see if there's history. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And there's, um, we don't have any history on file for [PII] yet.
[CUSTOMER][NEUTRAL] Oh, OK. And what about downgrades for composite and crows and, uh, a major paid on prep data or sea date.
[AGENT][NEUTRAL] Um, there's no
[CUSTOMER][NEUTRAL] Would that be also mentioned on the parts?
[AGENT][NEUTRAL] There's no specification to the prep or seat date. There's no downgrades, and what was the last part?
[CUSTOMER][NEUTRAL] OK, uh, that's it, uh, the downgrades and the, uh, sheet of update.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I thought I missed one.
[CUSTOMER][NEGATIVE] Uh no.
[CUSTOMER][POSITIVE] OK, then. That's, that's all from my end then. Thank you so much for your help.
[AGENT][POSITIVE] Well, you're very welcome, [PII]. You also, and thanks for calling APL.
[CUSTOMER][POSITIVE] Have a great day.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][POSITIVE] You're welcome.