AccountId: 011433970860
ContactId: c9cee121-9cfc-445b-a018-c88be96e8573
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202779 ms
Total Talk Time (AGENT): 106131 ms
Total Talk Time (CUSTOMER): 87774 ms
Interruptions: 0
Overall Sentiment: AGENT=2.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/c9cee121-9cfc-445b-a018-c88be96e8573_20250108T22:27_UTC.wav
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[CUSTOMER][NEUTRAL] It
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Doctor [PII]'s office. I was calling to verify, see if the providers and network with the patients plan and get benefits.
[AGENT][NEUTRAL] OK, sure, I can assist you with benefits or network information, Ms. [PII]. Um, may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh huh [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Mhm it is 02581052.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, it is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you. And let's see. OK, so this particular policy is one of our dental policies, and with this one, if the provider participates with Carrington PPO they can use their fee schedule. If not, we pay on the usual and customary rate. There's no network. Um, do you need benefits?
[CUSTOMER][NEUTRAL] You said she's under a dental plan?
[AGENT][NEUTRAL] Yeah, this is a dental. Are you looking for medical?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me see if there's a medical plan. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Did you
[AGENT][NEUTRAL] OK. I did find a medical plan. Um, we have a limited hospital indemnity plan for this member. And what type of service is being rendered?
[CUSTOMER][NEUTRAL] A specialist office is it?
[AGENT][NEUTRAL] OK, let me go ahead and give you the benefit, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer and again with this one, there's no network, OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, let's see. So this one covers $50 per visit, maximum of 4 visits per person per calendar year.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. And the $50 is a flat amount.
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] And that's what the plan covers $50? OK, so plan covers $50 and then she's responsible for any other charge, right?
[AGENT][POSITIVE] Yes, correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and then no network it doesn't matter if providers in or out.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, alrighty then that would be all for me today. Can I get that reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Sure. That's [PII]. Last initial is [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] All kinds of things, oh, that's a bad that's a strike.
[CUSTOMER][POSITIVE] Alrighty thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Is there anything else I may help you with today, Miss [PII]?
[CUSTOMER][POSITIVE] No, that would be all thank you.
[AGENT][POSITIVE] Thank you. You're welcome. Have a good afternoon.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] You're welcome. Bye bye.