AccountId: 011433970860
ContactId: b8473e2b-088b-4c43-889e-c838e45947ad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 652989 ms
Total Talk Time (AGENT): 166365 ms
Total Talk Time (CUSTOMER): 116796 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/b8473e2b-088b-4c43-889e-c838e45947ad_20250321T17:04_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is So. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling to get a verbal breakdown for a patient that we have in the office and also to see if um my doctor's in network um because I haven't um who is this insurance through?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, this is APL.
[CUSTOMER][NEUTRAL] They couldn't tell me.
[AGENT][NEUTRAL] Oh, OK. All right, no problem. Um, may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] My name is [PII]. Call back number [PII] at option 2.
[AGENT][NEUTRAL] use the option 2.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and may I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Um, Aspen Dental or Hay Dental LLC.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] They gave me a member ID of 60801 so I got their social. Will that work?
[AGENT][NEUTRAL] Um, yep, give me just a second, let me go ahead and pull another system.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, what's um the name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And may I have his date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And you said you need this information given to you verbally, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me start off by giving you the correct policy number. Let me know when you're ready.
[CUSTOMER][POSITIVE] I am ready when you are.
[AGENT][NEUTRAL] OK, the policy number is 02.
[AGENT][NEUTRAL] 50
[AGENT][NEUTRAL] 28
[AGENT][NEUTRAL] 95
[AGENT][NEUTRAL] Effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it is active at the moment.
[AGENT][NEUTRAL] This is a dental policy, and this one pays on the usual and customary rate UCR there's no network.
[CUSTOMER][NEUTRAL] OK, um, could I get the group name?
[AGENT][POSITIVE] Sure, yes, let me get that for you one moment.
[AGENT][NEUTRAL] OK, so the group name is Universal Trucking Quest Lir.
[CUSTOMER][NEUTRAL] Universal Trucking and then what's that last word?
[AGENT][NEUTRAL] Quest
[AGENT][NEUTRAL] Liner.
[CUSTOMER][NEUTRAL] OK, and can I get that group number?
[AGENT][NEUTRAL] It is 17238.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The what is the name of the carrier where we file claims?
[AGENT][NEUTRAL] American Public Life Insurance or APL.
[CUSTOMER][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] And the number you were giving me in the beginning, that's the pay ID that's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is the claim's mailing address?
[AGENT][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Is there any other like um.
[CUSTOMER][NEUTRAL] Name that it could it could file under other than American Public Life is it under like a denimax network or?
[AGENT][NEUTRAL] Mhm. No, it's gonna be American Public Life or APL.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] OK, that's coming as an indemnity plan.
[AGENT][NEUTRAL] We have many plans including indemnity policy, cancer, um, many, many plans, secondary supplementals, but this one is a dental.
[CUSTOMER][POSITIVE] OK, good
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, could I just get um.
[CUSTOMER][NEUTRAL] Could I just get a fax back um because I'm, I have a feeling my system is gonna gonna deny it so I'm gonna just send it to one of my higher ups because we don't take indemnities like this.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, well, this one is not an indemnity, but I can go ahead and send you a fax back so you have that information. What is the fax number?
[CUSTOMER][NEUTRAL] The fax number is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] yeah our system just is popping it up as an indemnity plan um because our system only gives us certain options I can't just like type it in and it and and it be correct um it only gives me certain options so if my system doesn't take it then that's that's the issue, yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Got you. Oh, OK. Yeah, it's probably because we do have one that is an indemnity, but we have many plans, so it's not just one specific one. we have like 33 or 4 different products and they're all different, um, but let me go ahead and send this out to you. That's 205631-0145.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] OK, do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK, thank you, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for Ms. [PII]. Yeah, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] That is all thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good evening.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Mm.