AccountId: 011433970860
ContactId: e21ce2dd-d009-4623-9671-988baaed0d56
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254389 ms
Total Talk Time (AGENT): 142371 ms
Total Talk Time (CUSTOMER): 60008 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/e21ce2dd-d009-4623-9671-988baaed0d56_20250207T15:26_UTC.wav
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[AGENT][POSITIVE] Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning. My name is [PII]. I'm calling from a dental provider's office and I'm just trying to verify eligibility and get a breakdown if possible.
[AGENT][POSITIVE] [PII], it would be a pleasure to help you with that eligibility and breakdown. What is the callback number, please?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] It is 02475724.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] [PII] in the [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][POSITIVE] I am getting her policy pulled up and I'm showing that her dental policy is active.
[AGENT][NEUTRAL] Effective date is 3, well, yeah, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there a group name for this policy?
[AGENT][POSITIVE] There is a good name. Let me get that for you.
[AGENT][NEUTRAL] Group name is Man.
[AGENT][NEUTRAL] Analysis.
[AGENT][NEUTRAL] And utilization.
[CUSTOMER][NEUTRAL] OK, give me just one second.
[AGENT][POSITIVE] Sure, and if you need the group number, I can provide that as well.
[CUSTOMER][POSITIVE] Yes ma'am, please.
[AGENT][NEUTRAL] My group number is 70056.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then what fee schedule would this follow? Is it under Carrington?
[AGENT][NEUTRAL] It follows the uh it does participate in the Carrington PPO network, but network participation is not required. We pay both in and out of network benefits.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEGATIVE] And it is a limited dental benefit. It does not cover major procedures.
[CUSTOMER][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] And then could you give me the claims address?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] 950.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Oklahoma.
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] Now on this breakdown I can fax to you it will have the calendar year max deductibles, frequencies, limitations, it'll have the billing information.
[AGENT][NEUTRAL] And um also the.
[AGENT][NEUTRAL] It'll have the mailing address, payer ID, and fax number.
[CUSTOMER][NEUTRAL] OK, so it'll have like the full breakdown.
[AGENT][NEUTRAL] Yes ma'am, it'll have the frequencies and limitations, um, it'll have the coverage as well as the procedures listed that are covered and at what percentage if they're considered preventive or basic.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. That is perfect.
[AGENT][POSITIVE] And what is that fax number? I can go ahead and get this on the way for you.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Just to verify that fax number I am sending this to [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right. And also, [PII] has no history.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] On file.
[AGENT][POSITIVE] And that fax is on the way. You should, you alright, well you should be receiving that fax shortly, and [PII], it has been a pleasure to assist you with that breakdown. If you have any questions once you receive that fax, please give us a call back. We'll be happy to discuss that with you, and I hope you have a great day and a happy weekend.
[CUSTOMER][NEUTRAL] Alright, I think that is everything.
[CUSTOMER][POSITIVE] You too. Thank you so much.
[AGENT][POSITIVE] Thank you, [PII]. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.