AccountId: 011433970860
ContactId: e1193eac-885f-4e4d-b4d2-0cc166bdd88a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 362190 ms
Total Talk Time (AGENT): 155093 ms
Total Talk Time (CUSTOMER): 119173 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/e1193eac-885f-4e4d-b4d2-0cc166bdd88a_20250303T19:45_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good afternoon. My name is [PII]. I'm calling just to verify eligibility and benefits on this patient's plan.
[AGENT][NEUTRAL] OK, [PII], you're needing to verify eligibility and benefits for members, is that correct?
[CUSTOMER][POSITIVE] Correct, yep.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] 01983869
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you're calling on a dental policy, is that correct?
[CUSTOMER][POSITIVE] Correct, yep.
[AGENT][NEUTRAL] OK, so for our dental policies we do have fax facts of the member's benefits that I will send to you. So we'll have all of the covered services listed on there, [PII]. So give me just one minute one my.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The member's information is loading.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name please and date of birth?
[CUSTOMER][NEUTRAL] Patient is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, I'm so sorry, what was the first name again?
[CUSTOMER][NEUTRAL] [PII] or [PII]?
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] no, I'm looking at the wrong patient. I'm so sorry.
[AGENT][NEUTRAL] That's gonna
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] [PII], so [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that he is the subscriber on this dental plan and this policy is active, Carla, with an effective date of [PII].
[CUSTOMER][NEUTRAL] Is this a PPO plan or?
[AGENT][NEUTRAL] This, this policy does provide it participates in the Carrington PPO network but they are not required to use a network provider.
[CUSTOMER][NEUTRAL] What's the company?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But it does.
[CUSTOMER][NEUTRAL] So what's the what's the insurance name? Is it just Carrington?
[AGENT][NEUTRAL] APL
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] Carrington is the network.
[AGENT][NEUTRAL] The insurance is through APL.
[CUSTOMER][NEUTRAL] A as in Alpha. P as in Peter, L for Lima.
[AGENT][NEUTRAL] Correct. American Public Life. Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] And that information should be on his ID card also?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, are you able to send that fax back just so I can avoid a bunch of questions? OK.
[AGENT][POSITIVE] Absolutely. Yes, ma'am. Sure. I'll be happy to. It's loading, so give me just a moment. You can go ahead and give me your fax number.
[CUSTOMER][NEUTRAL] Yep it is [PII].
[CUSTOMER][NEUTRAL] [PII] yeah.
[AGENT][NEUTRAL] OK, does it need to have your name on it or is that not necessary?
[CUSTOMER][POSITIVE] No, no, not necessary, thank you.
[AGENT][POSITIVE] OK. You're welcome.
[AGENT][NEUTRAL] OK, and again that fax number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Correct, yep.
[AGENT][NEUTRAL] OK, well, I have just sent that to you and anything that is not on the fax that means it would not be covered under his plan, [PII]. And then also once if you will file a claim with APL once it has been processed, we do have a portal that you should be able to check claim status in by going to [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, the claims address and everything would be on the fax back?
[AGENT][NEUTRAL] It is, yes ma'am, uh huh, along with our payer ID and all of that, mhm.
[CUSTOMER][POSITIVE] OK all right perfect.
[CUSTOMER][POSITIVE] Beautiful and then I just need to know is he eligible for.
[CUSTOMER][NEUTRAL] A panoramic X-ray.
[CUSTOMER][NEUTRAL] I can give you the code if you need it.
[AGENT][NEUTRAL] Yes, ma'am. I'll have to have that, but give me just one second.
[CUSTOMER][POSITIVE] Yeah, no worries.
[AGENT][NEUTRAL] OK, and what is the code?
[CUSTOMER][NEUTRAL] 0330.
[AGENT][NEUTRAL] Uh, we do not have any history on file for him for that.
[CUSTOMER][NEUTRAL] No history. OK, awesome and then um do I need to send like a pre-approval for.
[CUSTOMER][NEUTRAL] Extractions.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Uh, no, ma'am, it is not required.
[CUSTOMER][NEUTRAL] OK perfect um I think that's all I'm gonna need everything else I guess I'll just wait for the fax back.
[CUSTOMER][NEUTRAL] Um, let me see one there.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] OK, yep, that's fine. All right, thank you so much for your help that's all I'm gonna need for today.
[AGENT][POSITIVE] Well, OK. Well, if that's all then that I can help you with, thank you for calling APO and I hope you have a great afternoon, [PII].
[CUSTOMER][POSITIVE] Thanks you as well have a good one.
[AGENT][POSITIVE] Yes, ma'am. Thank you.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] All right bye bye.