AccountId: 011433970860
ContactId: e56ebe12-a1c8-4ca3-92c9-07f21401e539
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 552780 ms
Total Talk Time (AGENT): 234574 ms
Total Talk Time (CUSTOMER): 134640 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/e56ebe12-a1c8-4ca3-92c9-07f21401e539_20250304T15:14_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] Hi [PII], my name is [PII], and I'm calling from the rental office for rental eligibility benefits on a recorded line. Could you please help me with that?
[AGENT][NEUTRAL] OK, [PII]. My name is [PII] and you're needing
[CUSTOMER][POSITIVE] A choice. I'm so sorry.
[AGENT][NEUTRAL] That's OK. That's OK. And you're needing eligibility and benefits on a dental policy?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And then, yes.
[AGENT][NEUTRAL] Yes, ma'am, I can help you with that. And [PII], on our dental policies, we have fax backs of the members' benefits that I will send to you, that will have all of their information on there. And what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, that'll be [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have here 60801.
[AGENT][NEUTRAL] OK, that's our electronic payer ID.
[CUSTOMER][NEUTRAL] Oh, can I do the name and date of usage?
[AGENT][NEUTRAL] I can't search by the date of birth, no, ma'am. Do you not have a copy of the ID card?
[CUSTOMER][NEUTRAL] How about the name?
[CUSTOMER][NEUTRAL] No, how about the patient's name and last name?
[AGENT][NEUTRAL] I can try by the name, [PII], but if it's a very common name, that may be difficult. What is the last name?
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] First name?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII] Is that correct?
[CUSTOMER][NEUTRAL] Yeah, yes, yes.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you said the last name is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK one moment [PII], I mean [PII], I'm sorry.
[CUSTOMER][POSITIVE] That's OK, no problem.
[AGENT][NEUTRAL] I don't know where that came from. So sorry.
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEUTRAL] OK, so I believe I've located a policy. Any information that I provide would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Again, mhm.
[AGENT][NEUTRAL] OK, thank you. So I have located a policy in which he is the subscriber and the policy is active effective 8-12-2024.
[AGENT][NEUTRAL] And the policy, yes, ma'am, the policy number is 252.
[CUSTOMER][NEUTRAL] 8 12 2024.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 0644.
[AGENT][NEUTRAL] And we do not have any history on file for him at this time.
[CUSTOMER][NEUTRAL] And how about their group name and group number?
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] The group number is going to be just one moment.
[AGENT][NEUTRAL] The group number is 70073.
[AGENT][NEUTRAL] The group name is is long.
[AGENT][NEUTRAL] It is, I'm gonna spell it for you. The first word is V E R S T E L A.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Space, put a space and then a capital A, and then another space.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Terra, which is T E R R A.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Services.
[AGENT][NEUTRAL] LLC Company.
[CUSTOMER][NEUTRAL] And I I'll, I'll also be needing the fee schedule here for the time.
[AGENT][NEUTRAL] OK, yes ma'am. This is all on the fax back that I'm going to send you. This plan participates in the Carrington PPO network. However, utilization of a provider within the Carrington network is not required.
[CUSTOMER][NEUTRAL] OK. And for the COB is it?
[AGENT][NEUTRAL] And what is
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Standard or non-tu?
[AGENT][NEUTRAL] Standard
[CUSTOMER][NEUTRAL] And is there any missing calls waiting period?
[AGENT][NEUTRAL] There is and there's no waiting periods.
[AGENT][NEGATIVE] There is a missing taste clause and all of this information is also on the fax back.
[CUSTOMER][NEUTRAL] OK, and the.
[CUSTOMER][NEUTRAL] Uh, you, uh, and your max and deductibles will all be in effect, right?
[AGENT][NEUTRAL] Yes, ma'am, that is correct. Uh-huh. Mailing address, all of that is for claims and all of that's also on there. And again, anything not listed on the fax that can means it is not covered by the policy.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it. You said it's it mm.
[CUSTOMER][NEUTRAL] And also, is this count year plan or benefit year?
[AGENT][NEUTRAL] Calendar year?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh yes, and are there any downgrades for the downgrades will be there in the effects for the fillings and crowns.
[AGENT][NEGATIVE] There are not.
[AGENT][NEGATIVE] No downgrades and there's no coverage for major.
[CUSTOMER][NEUTRAL] No cover. OK, no coverage for major. And for the SRP can all the 4 quotes be done on the same day?
[AGENT][NEUTRAL] Again, all of this information is on the fax back, or do you not need that sent?
[CUSTOMER][NEUTRAL] OK, you can provide me the fax.
[AGENT][NEUTRAL] And what is your fax number, [PII]?
[CUSTOMER][NEUTRAL] Sure, that'll be [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] No major coverages.
[AGENT][NEUTRAL] And [PII], will the facts need to have be put to your attention or is that not necessary?
[CUSTOMER][NEUTRAL] Yes, it could put to my attention, [PII].
[AGENT][NEUTRAL] Attention [PII], OK.
[AGENT][NEUTRAL] And again, your fax number was [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK. So I have just sent that to you, [PII], so you should be receiving that uh within just the next few minutes, uh, probably less than 10 minutes. And again, um, anything not on the fax that means it would not be covered.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And if you all do file a claim with APO once the claim has been processed, we do have a portal in which you should be able to check claim status and by going to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you. And that will be it, [PII]. Thank you very much for your time and help. I really appreciate it. You have a wonderful day.
[AGENT][POSITIVE] Well, you are certainly, uh, well, thank you, [PII], if that's all I can help you with. I hope you have a nice day too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Uh-huh. Bye-bye.