AccountId: 011433970860
ContactId: dea06ce2-d488-47fa-8f20-20df1c71741d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254789 ms
Total Talk Time (AGENT): 135060 ms
Total Talk Time (CUSTOMER): 63147 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/dea06ce2-d488-47fa-8f20-20df1c71741d_20250107T21:01_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][POSITIVE] Yeah, I'm trying to get dental benefits for a patient.
[AGENT][POSITIVE] OK, I'd be glad to help you. Go ahead and give me your name and the member's policy number, please.
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] Alright, here, and the policy number please, ma'am?
[CUSTOMER][NEUTRAL] 02569905
[AGENT][NEUTRAL] All right, [PII], thank you for all that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, [PII], thank you for all that information. Now what's your patient's name and date of birth today, please, ma'am?
[CUSTOMER][NEUTRAL] I've got [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] All right, looks like [PII] is a dependent on this dental plan. Original effective date is [PII]. Patient is current and active, but I must advise the verification of coverage is not a guarantee of payment on the claim, but you did say you want to fax back a benefit. Is that correct, [PII]?
[CUSTOMER][POSITIVE] That'll be great, yes.
[AGENT][POSITIVE] Yes, ma'am. Good fax number, please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Not here. I'm gonna repeat that fax. I'm about to make sure that I'm keying this in correctly. That is area code [PII]. Was that the correct fax number?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Alrighty, you should have this very detailed fax back a benefit in just a couple of minutes. Now it is very detailed on what's covered and what's not. So if the procedure code is not on this fax, it is not covered here at all, and the only thing that will not be on this fax would be the PPO network name. Let's see. Looks like this patient is in Carrington PPO networked here, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Does it show the claims address on there?
[AGENT][POSITIVE] Yes, ma'am, it does.
[CUSTOMER][NEUTRAL] OK, can I just give you a couple of codes just in case I don't get it within the next few minutes so I can make sure what it'll cover?
[AGENT][NEUTRAL] Sure, go ahead.
[CUSTOMER][NEUTRAL] OK, so I need D1120?
[AGENT][NEUTRAL] Alright, give me just a moment. Let's see.
[AGENT][NEUTRAL] But you wanna know if it's covered?
[CUSTOMER][NEUTRAL] Yeah, and if it does pay 100%.
[AGENT][NEUTRAL] 112
[AGENT][NEUTRAL] Yes, it is preventative, so that will be at 100% and no deductible and of course I can always take these benefits cannot guarantee payment over the phone, but yes ma'am, that is preventative.
[CUSTOMER][NEUTRAL] OK, can I give you two other codes just to double check?
[AGENT][NEUTRAL] Sure, go ahead.
[CUSTOMER][NEUTRAL] D0150.
[AGENT][NEUTRAL] 0150. Let's see.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And then D0272.
[AGENT][NEUTRAL] What? Tell me that code one more time.
[CUSTOMER][NEUTRAL] D0272
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Yeah, 0150, that's preventative, that's payable 100% and you said 272 that's by rings, yes ma'am, all preventative.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, all right, thank you so much alright have a good day.
[AGENT][POSITIVE] Yes, ma'am. Yes, ma'am. And is that all I can help you with? Mhm.
[CUSTOMER][POSITIVE] Yes ma'am, I'll be waiting on your back. Thanks.
[AGENT][POSITIVE] OK, T. Yes, ma'am, it is on its way then T, and thanks for calling APO. Have a great day.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yes, ma'am. Bye-bye.