AccountId: 011433970860
ContactId: d6cb6343-1e9e-4d70-b03a-550f0bb4ca2c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 478239 ms
Total Talk Time (AGENT): 201174 ms
Total Talk Time (CUSTOMER): 84115 ms
Interruptions: 1
Overall Sentiment: AGENT=1.8, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/d6cb6343-1e9e-4d70-b03a-550f0bb4ca2c_20250414T19:25_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I was just calling for eligibility for a patient.
[AGENT][NEUTRAL] OK, [PII], you're only needing eligibility. You do not need benefits, is that correct?
[CUSTOMER][POSITIVE] Yeah, benefits as well.
[AGENT][NEUTRAL] You need both? Is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that, [PII] and what is a good call back number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] Policy number is 025176550.
[AGENT][NEUTRAL] OK, thank you one moment please while I get the member's information.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And pulled up.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Give me just a moment, lady. I'm having trouble with one of my screens. I'm sorry.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Let me just reopen something. I, I do apologize about the delay.
[AGENT][NEUTRAL] I had one of them time out on the end so.
[CUSTOMER][NEUTRAL] It's Monday. The computers fill it too.
[AGENT][NEUTRAL] And that's a choice.
[AGENT][NEUTRAL] Alright, so give me just a second.
[CUSTOMER][NEUTRAL] There's a spring arts festival at the um fairground.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So [PII].
[AGENT][NEUTRAL] OK, there we go, [PII]. So any information that I do provide would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Alright, give me just
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Alright, so I do show that she is, this is for dental that you're calling for benefits and eligibility?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so she is the subscriber on this dental plan and yes ma'am, it is active.
[AGENT][NEUTRAL] The effective date on it is [PII].
[AGENT][NEUTRAL] And on our dental policies, [PII], we have fax.
[AGENT][POSITIVE] A of the benefits.
[AGENT][NEGATIVE] That I'll be sent to you and anything not on this fax back means it would not be covered under her plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so I'm gonna place you just if that's OK because I'm still having trouble getting this one screen to load properly for me, um, just so I'm gonna place you on a brief hold, OK?
[CUSTOMER][NEUTRAL] OK, that's fine.
[AGENT][POSITIVE] Thank, OK, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, [PII], thank you again for holding for me. So yes, ma'am, as I stated, the policy is active with an effective date of [PII], and she does not have any history on file with APL.
[CUSTOMER][NEUTRAL] OK, and APL is the company for the dental?
[AGENT][POSITIVE] That, that is correct.
[CUSTOMER][NEUTRAL] Is there a website in which I could like log in and view benefits or no?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] No. Um, and everything that I'm going to send you on this fax back is what is covered under her plan. Anything not on the fax back is not covered. And it's going to list the categories.
[CUSTOMER][NEUTRAL] Does she have out of network coverage?
[AGENT][NEUTRAL] This plan participates in the Carrington PPO network, however, they are not required to to use a network provider. This participates with Carrington.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK, and then I can give you the fax number.
[AGENT][NEUTRAL] OK, does it need to be put to your attention though, or is that not necessary?
[CUSTOMER][NEUTRAL] No, it's not necessary.
[AGENT][NEUTRAL] OK, one moment there
[AGENT][NEUTRAL] OK, and what is a good fax number for you, please, [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, I'm just gonna repeat that back. [PII].
[CUSTOMER][POSITIVE] Yes ma'am, that's correct.
[AGENT][POSITIVE] OK, so I have just sent that to you so provided there's not any type of technical mishap, you should be receiving that within the next few minutes.
[CUSTOMER][NEUTRAL] OK, and then that'll have the maximums and deductibles and everything like that as well?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It does, yes ma'am, it does, and it has our mailing address, payer ID, the information about the network and all that's on there, yes.
[CUSTOMER][POSITIVE] OK awesome.
[CUSTOMER][POSITIVE] OK awesome thank you so much.
[AGENT][NEUTRAL] And then you're welcome. One last thing, [PII], if you all end up filing a claim with APL once the claim has been processed by us, we do have a portal in which you should be able to check claim status, and the portal website is located at secured.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] So that was secured.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Mhm. A um uh-huh. That's correct. Yes, ma'am.
[CUSTOMER][POSITIVE] Got you, thank you, ma'am.
[AGENT][POSITIVE] OK. Well, you are certainly very welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No that'll be it.
[AGENT][POSITIVE] OK, well thank you so much for calling APL and I hope you have a wonderful rest of your day.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][POSITIVE] Thank you too. Bye-bye.