AccountId: 011433970860
ContactId: dab6e4cf-c17c-4655-b474-562aeaaa0785
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 437380 ms
Total Talk Time (AGENT): 154827 ms
Total Talk Time (CUSTOMER): 120483 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/dab6e4cf-c17c-4655-b474-562aeaaa0785_20250331T14:17_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning Ms. [PII]. My name is [PII]. I'm calling from a dental office. Want to get a breakdown of benefits for a patient.
[AGENT][NEUTRAL] OK, you said that your name is [PII], is that?
[CUSTOMER][NEUTRAL] Mhm yes ma'am.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, [PII], and you're needing to get a dental breakdown for a member, a fax back?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Is that correct? Yes ma'am, I can help you with that and a call back number for you please?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] Member's policy number is gonna be 02567778.
[AGENT][NEUTRAL] OK, thank you one moment while I get that information pulled up.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And [PII] and any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Patient's name is gonna be [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] So I do show that Ms. [PII] is there on the dental policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, are we in network with this policy?
[AGENT][NEUTRAL] This part this plan participates with the Carrington PPO network. however, they are not required to use a network provider.
[CUSTOMER][NEUTRAL] OK, perfect. And what's your plan maximum and deductibles?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] And this information just so you know, will also be on the fax max. She has a calendar year max of $500 per covered insured and a calendar year deductible of $50 per covered insured.
[CUSTOMER][NEUTRAL] OK, has any of that been used or met?
[AGENT][NEUTRAL] No, ma'am. It has not.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] And just a quick question, what is the percentage of coverage for cold?
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] D 7210 and D 6010.
[AGENT][NEUTRAL] OK, 72 and the other one is what?
[CUSTOMER][NEUTRAL] 6010.
[CUSTOMER][NEUTRAL] 6010.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] 722.
[AGENT][NEGATIVE] And it's not covered.
[AGENT][NEUTRAL] And neither is 6010.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Neither are covered under this policy.
[CUSTOMER][NEUTRAL] OK, what about um 6104?
[AGENT][NEGATIVE] Mm, that one is also not covered.
[CUSTOMER][NEUTRAL] OK, and are we using the Carrington, mhm.
[AGENT][NEUTRAL] This policy only has benefits.
[AGENT][NEUTRAL] I'm sorry, this policy only has preventative and basic expenses.
[CUSTOMER][POSITIVE] Oh, got you. OK, perfect. And any um waiting periods on anything?
[AGENT][NEUTRAL] Benefit
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK perfect and we're just using the Carrington um 500 series P schedule?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Alright perfect thank you so much Miss [PII]. I'm gonna look for that fax back.
[AGENT][POSITIVE] You're welcome. And what is a good?
[AGENT][NEUTRAL] Yeah, well, what is your fax number that I can send this to?
[CUSTOMER][NEUTRAL] Oh I'm sorry, I never gave it to you that I said it's 770.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 631.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so give me just a moment please to get that up, OK?
[CUSTOMER][POSITIVE] Alright perfect thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] It takes a moment to load this.
[CUSTOMER][NEUTRAL] OK, that's OK.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] We
[AGENT][NEUTRAL] And again, you said that your fax number is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am mhm.
[AGENT][NEUTRAL] Alright, well I have just sent.
[AGENT][NEUTRAL] That to you and then one additional thing um Aan been processed with APL we do have a portal in which you can check claim status and our port.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Portal is [PII].
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] All right. Well, you are certainly so welcome. And is there anything else that I can
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Can help you with?
[CUSTOMER][NEUTRAL] No ma'am, that is it.
[CUSTOMER][POSITIVE] No ma'am, that's it thank you so much.
[AGENT][POSITIVE] OK. Well, then, thank you again for
[AGENT][POSITIVE] Well, you're welcome and thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Alright you as well thank you.
[AGENT][POSITIVE] Yes, ma'am. Thank you too.
[CUSTOMER][POSITIVE] Mhm thank you bye.
[AGENT][NEUTRAL] Bye bye.