AccountId: 011433970860
ContactId: b0c3203e-b64a-4be2-8d30-da2857c53229
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 328799 ms
Total Talk Time (AGENT): 175800 ms
Total Talk Time (CUSTOMER): 133633 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/b0c3203e-b64a-4be2-8d30-da2857c53229_20250519T20:49_UTC.wav
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[AGENT][POSITIVE] Thank you for calling EPL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Thank you for calling
[CUSTOMER][NEUTRAL] Hi. Um, I'm new with this insurance company.
[CUSTOMER][NEUTRAL] And I'm gonna need some dental care.
[CUSTOMER][NEUTRAL] But I was told that you pay very little, so can you tell me more or less how much you would pay so that I can have an idea and save up the rest? I'm sorry?
[AGENT][NEUTRAL] Sure we could take a look.
[AGENT][NEUTRAL] Absolutely, yeah, we can take a look at your dental policy and uh check those benefits out. Um, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] OK, right now I'm at [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. Do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, I do. Policy number or certificate, it's uh 0261.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 7051.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] Alright, I'm just gonna verify some information really quick uh [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] Sure. That's [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. Last thing I need is the email address we've got on file for you uh looks like that is a [PII] account.
[CUSTOMER][NEUTRAL] A what?
[AGENT][NEUTRAL] Uh, verify the email address we have please. It looks like it is the [PII] account.
[CUSTOMER][NEUTRAL] Uh, the email account is, hold on, because I never remember it. Hold on, hold on.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Almost there.
[CUSTOMER][NEUTRAL] See
[CUSTOMER][NEUTRAL] That is [PII]
[CUSTOMER][NEUTRAL] My last name [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alright, thank you so much for verifying all of that, [PII]. OK, so I do have your policy pulled up here, um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm not sure when people what you mean when people say that like it doesn't pay much. This is a very basic plan. Uh, that being said, it does offer preventative and basic coverage. It just does not have any major coverage. So anything like um oral surgery, uh, you know, crowns, things like that are not going to be covered under this policy. So under this policy, you've got.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] So the crowns would not, crowns would not be covered? No.
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] Right, this one is very basic.
[CUSTOMER][NEGATIVE] Crowns would not be covered.
[AGENT][NEUTRAL] That's correct, um, so it's those.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But feelings are, feelings are?
[AGENT][NEUTRAL] It can be um it really depends. There are multiple different kinds of fillings so it depends on the process that the um your provider would use but most of the time that is going to be considered basic, which would be covered under this policy. So to put it into perspective, this policy doesn't pay a set dollar amount.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] It does participate in the Carrington uh PPO network and pays a percentage, so preventative, so things like cleanings, um, oral evaluations, those are going to be at 100% covered and then basic, um, and then like X-rays and things like that that's gonna be covered at 80%.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK, so she has to have 2 crowns.
[AGENT][NEUTRAL] Uh oh.
[CUSTOMER][NEUTRAL] And two fillings. So that means that uh only the fillings would be covered in the checkup, but nothing else.
[AGENT][NEUTRAL] Yeah, crowns are not going to be covered under this policy. Um, what I would recommend doing is having the provider wherever uh she's going for treatment, um, giving us a call and that way they'll have those exact what they call procedure codes, uh, the ones that they'll use, and we'll be able to go over that information with them.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, well,
[CUSTOMER][NEUTRAL] And we'll be
[CUSTOMER][NEUTRAL] OK, because I just went with them through that and they they just ended up telling me the total amount you're gonna be needing is $3,324.
[AGENT][NEUTRAL] Yikes.
[CUSTOMER][NEUTRAL] OK. And again, that would be for a checkup, a cleaning and two fillings and 2 crowns. And I said, OK, so, um, I guess I would have to
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Pay the difference.
[AGENT][POSITIVE] And for whatever is not covered um that would be completely up to them again for the sake of like you know resolving any sort of confusion I would simply have them give us a call they can submit what is called a pre-treat and essentially that's those exact codes that they would be using for those procedures sending it to us we would actually give them the dollar amount that we would cover and then uh they will be able to pass that information along to you.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you very much for your time. OK, take care.
[AGENT][POSITIVE] You are very welcome. Did you have any other questions for me?
[CUSTOMER][NEUTRAL] No, thank you. Bye-bye.
[AGENT][POSITIVE] All right have a great rest of your day. Yes ma'am. Bye bye.
[CUSTOMER][NEUTRAL] You too, bye bye.