AccountId: 011433970860
ContactId: a94271cb-039b-49d8-866b-2c7d62b1a5af
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 462179 ms
Total Talk Time (AGENT): 87666 ms
Total Talk Time (CUSTOMER): 154475 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/a94271cb-039b-49d8-866b-2c7d62b1a5af_20250205T19:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm giving you a call from Westwood Dental Smiles, and I'm calling to verify members, uh, dental eligibility and benefits. May I place you on hold, sir, for just a quick second?
[AGENT][POSITIVE] Yeah, absolutely.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Uh, thank you for holding, [PII].
[AGENT][POSITIVE] Yeah, no problem.
[CUSTOMER][NEUTRAL] OK, perfect. Um, so yeah, I needed to check on members, um, dental eligibility and benefits and to see if she has any out of network coverage since my doctor is not in network with your dental insurance and see how her plan works.
[AGENT][NEUTRAL] OK, let's take a look. What's the policy number?
[CUSTOMER][NEUTRAL] Um, it is a policy certificate number is 02576121?
[AGENT][NEUTRAL] Can I get the patient's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] Uh, yeah, it is [PII], uh, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Alright, thank you so much for that. So the payment plan is active. The effective date is [PII].
[AGENT][NEUTRAL] It looks like the patient's policy does participate in the Carrington PPO network. However, a provider within the network's not required. The plan itself pays by UCR.
[CUSTOMER][NEUTRAL] OK, got you. OK, so got you, uh, the plan itself, OK, OK so ECR, and then also I know you said she just became effective [PII]. So does she have any waiting periods?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Uh, no, it looks like the patient's plan is really just preventative and basic coverage. We can send you a fact back if you need it, but, um, there's no waiting.
[CUSTOMER][POSITIVE] Yes, that'd be great.
[AGENT][NEUTRAL] OK. Yeah, there's no waiting periods for any of that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, that makes sense because I thought she had major coverage because she came in because of one of her veneers shipped, so that's why I wanted to check on that if she had coverage on veneers, but you just made it simple because if there's no major coverage, then veneers are not covered, so it makes my life easier, but still just to get a fax back so she could kind of see her breakdown in case she has questions.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Ah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah. Yeah.
[AGENT][POSITIVE] Yeah, absolutely. What's a good facts?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and that was 310208-3826?
[CUSTOMER][POSITIVE] Uh yes. And Miss [PII], you're good to go. We'll build your insurance should cover at 100%. OK, thank you. Have a good one.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] And I'm sorry about that. I'm trying to multitask here.
[AGENT][NEUTRAL] No, it's totally fine and should we mark the facts attention to anybody?
[CUSTOMER][NEUTRAL] How many
[CUSTOMER][NEUTRAL] Uh, no, it's fine. I'll, I'll get it.
[AGENT][NEUTRAL] OK, um, that is on its way. It should be there in about 5 minutes. Is there anything else I can help with today?
[CUSTOMER][NEUTRAL] Uh, yeah, well, last thing, uh, just to confirm, like in case, you know, uh, we do exam or X-ray or whatnot, is that covered at 100% through UCR or is there like a 80%? OK, got you. And then just to confirm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, preventative is at 100 and everything else is at 80.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Got you. And then just to confirm, um, what I have for the billing address for you guys is this American Public Life, is that correct?
[AGENT][POSITIVE] Uh-huh. Correct.
[CUSTOMER][NEUTRAL] And then it says [PII] [PII] and then it says [PII] and then electronic payer ID it says 60801.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] OK, perfect. OK, so then I'll just wait for that fax back and that was it. Thank you so much [PII], for your help. You have a great day.
[AGENT][POSITIVE] You're welcome. You too. Bye-bye.
[CUSTOMER][POSITIVE] Thanks bye.