AccountId: 011433970860
ContactId: ab2061f8-65aa-4325-a0bf-43cf64565d74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 412859 ms
Total Talk Time (AGENT): 132362 ms
Total Talk Time (CUSTOMER): 165515 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/ab2061f8-65aa-4325-a0bf-43cf64565d74_20250127T18:59_UTC.wav
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[AGENT][NEUTRAL] APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm actually calling from Professional Dental Alliance of Georgia. Um, how are you doing today?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] Good, good. Thank you for asking. The Reason for my call, I need to verify coverage and eligibility for a patient. I understand you guys have the option of sending a fax. The only thing not on the fax is the history. Is that correct?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, first, let me give you my telephone number.
[AGENT][POSITIVE] I'd be happy to
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] It's [PII]. It's a direct line.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And what is that uh policy number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] It is 02317211. It should come up as [PII].
[CUSTOMER][NEUTRAL] And then his date of birth is going to be [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] I do show.
[AGENT][NEUTRAL] The policy is active with an effective date of [PII].
[AGENT][NEUTRAL] Uh, one moment.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what is that fax number?
[CUSTOMER][NEUTRAL] [PII]. You can put it attention [PII] and that's just [PII].
[AGENT][NEUTRAL] Alright, you should receive that fax in the next 5 to 7 minutes. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] Um, yes. Is there any history on file for the patient for exam, X-rays, cleanings?
[CUSTOMER][NEUTRAL] Any period history?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] Extraction.
[AGENT][NEUTRAL] On [PII].
[AGENT][NEUTRAL] Extraction, extraction.
[AGENT][NEUTRAL] Oh, so that's it, [PII].
[CUSTOMER][NEUTRAL] Oh wow. No exam, no X-rays? Oh, OK.
[AGENT][NEUTRAL] Oh, I'm sorry, there's [PII], they had a um.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] FMX or pan. I have a feeling that's what you're going to say.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Bite wings.
[AGENT][NEUTRAL] So they had 00274.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] 00220 and 00230.
[CUSTOMER][NEUTRAL] OK, so they had vitamins and 2 PAs then. OK.
[CUSTOMER][NEGATIVE] And no exam code charged out.
[AGENT][NEUTRAL] Oh, I'm sorry. I see it on the, the last page, uh 00120 on the [PII].
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. No worries.
[CUSTOMER][NEUTRAL] And then, so now we're all familiar with APL. How does it work? Is it a traditional plan? Is this a PPO plan?
[AGENT][NEUTRAL] Um, well, with this plan, we are part of the Carrington, uh, PPO network, so it, it is a regular plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then if my provider, are we in network for the plan?
[AGENT][NEUTRAL] Well, that's the thing, the Carrington providers accept our coverage, but we don't have like a network of our own, so the patient can see any provider that they chooses. They don't have in or out of network benefits we're gonna pay what we're gonna pay to whomever.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, so for us that's more like a traditional plan because we like my doctor's not in network with Carrington, so for us it would be traditional.
[AGENT][NEUTRAL] So it would be UCR we would go by UCR.
[CUSTOMER][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yup. OK.
[CUSTOMER][NEUTRAL] All right. And then I'm
[CUSTOMER][NEUTRAL] I just make sure from what I understand, the patient said this is an individual plan.
[AGENT][NEUTRAL] Meaning he's the only one on the policy, correct?
[AGENT][NEUTRAL] Is that what he meant?
[CUSTOMER][NEUTRAL] I was wondering that question. I'm looking at his card now and it says, OK.
[AGENT][NEUTRAL] I think that's what he meant because he doesn't have any dependent. So, I, I think that's what he meant.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So then what's the group name? Is that gonna be the group volunteer, voluntary dental?
[CUSTOMER][NEUTRAL] I'm looking at his card.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I don't know about a name. Um, voluntary, I think there's not a name on the plan. I mean, it's just American Public Life, our company name, but.
[AGENT][NEUTRAL] I don't know about any specific thing.
[CUSTOMER][NEUTRAL] So there's no employer.
[AGENT][NEUTRAL] Oh, the employer is, no, there is an employer.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The employer's name is.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Universal Trucking.
[CUSTOMER][NEUTRAL] OK, that's what I was looking for. That's what we call that as a group name. OK, so Universal Trucking. OK.
[CUSTOMER][NEUTRAL] All right, because it looks like they were thinking it was, I don't know what MT select is, but Universal trucking, and then let me just confirm this group number. I just want to make sure this is accurate before we build this into our system. Um, I show the group number as I'm sorry, good gracious, my brain 19205.
[AGENT][NEUTRAL] Yeah, that's the group number, yes.
[CUSTOMER][NEUTRAL] OK, perfect. I just need a reference number for our call and that's it.
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call.
[CUSTOMER][NEUTRAL] [PII] and then I have [PII]. Is that good?
[AGENT][NEUTRAL] Uh, we're, um, Centric 106.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] OK. All right. Thank you so much, [PII]. You have a great rest of your day.
[AGENT][POSITIVE] Well thank you for calling APL. You do the same.
[CUSTOMER][POSITIVE] Thanks. All right. Thank you. Bye-bye.
[AGENT][NEUTRAL] Right.