AccountId: 011433970860
ContactId: c5c4812c-8f8f-44e7-afb0-29d8f6ba4140
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 689299 ms
Total Talk Time (AGENT): 172958 ms
Total Talk Time (CUSTOMER): 144593 ms
Interruptions: 4
Overall Sentiment: AGENT=0.9, CUSTOMER=-1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/c5c4812c-8f8f-44e7-afb0-29d8f6ba4140_20250424T15:40_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I'm, I'm calling for dental benefits.
[AGENT][POSITIVE] OK, sure. I can assist you with dental benefits. May I have your name?
[CUSTOMER][NEUTRAL] I'm calling from a provider's office.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected Miss [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII]. Alright thanks bye now.
[AGENT][NEUTRAL] And what's the name of the provider?
[CUSTOMER][NEUTRAL] [PII], last name [PII]
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] On
[CUSTOMER][NEUTRAL] Absolutely, so there's 500 in the front 00002588606.
[AGENT][NEUTRAL] OK. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] hold on.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, perfect, thank you. Um, do you need this benefit information given to you verbally or faxed over to you?
[CUSTOMER][NEUTRAL] Um, verbally, preferably because I was just talking to someone else and they were saying that um, this, uh, we were out of network so I was just calling to verify that and if so like what would they pay like percentage wise what would the copay be?
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, so this is one of our basic, let me pull their benefits.
[AGENT][NEUTRAL] OK, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, with this one, there is no network now if you participate with Carrington CPO, you can use that fee schedule.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and this one has a calendar year maximum of $500 with the $50 deductible and deductible does not apply to preventative.
[AGENT][NEUTRAL] Um, preventative start cover 100%.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Radiograph FMX is cover 80%. Basic expense and basic restorative is covered at 80%.
[CUSTOMER][NEUTRAL] with you right now.
[CUSTOMER][NEUTRAL] I couldn't even imagine I know like.
[AGENT][NEGATIVE] There's no major service. So endodontics, periodontics, prosthodontic repair, and oral surgery are not covered.
[CUSTOMER][NEUTRAL] OK, I just
[CUSTOMER][NEUTRAL] Well I told you I.
[CUSTOMER][NEUTRAL] Like, well, in case I need you.
[CUSTOMER][NEUTRAL] OK, well, are you able to check if she are we in network then or out of network?
[AGENT][NEUTRAL] There for us we're not contracted so for us there's no network. So if you do not participate with caring some PPO and you're not gonna be using the fee schedule we pay on their usual and customary rate UCR.
[CUSTOMER][NEGATIVE] I'm just a little lost now. I just don't know.
[CUSTOMER][NEUTRAL] Because it's a PPO plan.
[CUSTOMER][NEUTRAL] Correct?
[AGENT][NEUTRAL] It's not a PPO, no.
[AGENT][NEUTRAL] The commercial.
[CUSTOMER][NEUTRAL] It's no, well.
[CUSTOMER][NEUTRAL] Hey, OK.
[CUSTOMER][NEUTRAL] Do you mind also sending me a fax back breakdown of everything?
[AGENT][POSITIVE] Yeah, yes. Yes, that will help you a lot, I'm sure. OK, what is the fax number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] See right then.
[AGENT][NEUTRAL] OK, so that's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh, do you mind holding for me while I send this out to you right now?
[CUSTOMER][NEUTRAL] So you said that she has a $500 deductible.
[AGENT][NEUTRAL] No, the $50 deductible, the $500 is the maximum benefit.
[CUSTOMER][POSITIVE] Absolutely.
[AGENT][NEUTRAL] The deductible is just 50, but it's gonna be on the fax bank. So let me just go ahead and send this out to you, OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[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.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Ms. [PII]. Have you received the uh fax?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You have?
[CUSTOMER][NEUTRAL] Um, not yet, no, I have not.
[AGENT][NEUTRAL] Not yet. OK.
[CUSTOMER][NEUTRAL] I'm still waiting.
[AGENT][NEUTRAL] OK. Um, yeah, it may take a few minutes, but I did send that out to you. Um, it is really like detailed, so, um, more than likely you, you're gonna be able to use that to, to see exactly what you need to do with it. OK. Do you have any other questions for me, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I just need one more. I do. I just need to verify the group number.
[AGENT][NEUTRAL] OK. Yes.
[AGENT][NEUTRAL] Uh-huh, sure. The group number on this one is going to be, let's see.
[CUSTOMER][NEUTRAL] For me
[AGENT][NEUTRAL] 70078.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then what is the do you have an employer name possibly?
[AGENT][NEUTRAL] Yes, mhm, yes, it's [PII] Staffing Solutions.
[CUSTOMER][POSITIVE] Staffing solutions, OK, perfect, perfect, sounds good thank you so much for your help.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day. So.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.