AccountId: 011433970860
ContactId: e65082ed-4bb5-4ce5-944d-a44d8d3def65
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 346079 ms
Total Talk Time (AGENT): 181754 ms
Total Talk Time (CUSTOMER): 123708 ms
Interruptions: 4
Overall Sentiment: AGENT=0.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/e65082ed-4bb5-4ce5-944d-a44d8d3def65_20250415T14:30_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] Hi, yeah, my name's [PII]. I'm calling from Aspen Dental, and I just need to verify routine dental benefits for a patient. Can you assist me with this?
[AGENT][NEUTRAL] And you said your name is [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII], you're needing dental benefits on a member, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And [PII], also for our dental policies we have fax backs of the members benefits that I can send to you, um, that will have everything that's covered under their policy on there. So first off, [PII], what is a good call back number for you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] option 2.
[AGENT][POSITIVE] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] 02485969
[AGENT][NEUTRAL] Thank you, one moment please while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] I'm sorry, did you ask something?
[AGENT][NEUTRAL] No, ma'am, I didn't, not yet.
[CUSTOMER][NEGATIVE] Oh sorry.
[AGENT][NEUTRAL] No, that's OK.
[AGENT][NEUTRAL] I'm still getting the information loaded.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, 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 and their date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show she is the subscriber on this dental plan and it it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And there is no history.
[CUSTOMER][NEUTRAL] [PII] yeah.
[AGENT][NEGATIVE] Uh-huh. [PII] and as of now, there's no history on file.
[CUSTOMER][NEUTRAL] No history.
[AGENT][NEUTRAL] And what is a good fax number and I can send her benefit information to?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Yeah, uh [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. And will it need to have your attention on there, [PII], or is that not necessary?
[CUSTOMER][NEUTRAL] That's not necessary now and then whenever you send that I do have a couple quick questions that might not be on the fax.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And what type of question do you have?
[CUSTOMER][NEUTRAL] SRP 4341 and 4342 how many clouds per day?
[AGENT][NEUTRAL] That would be on the fax. 4341. That's, is that, is that what you said? Code 4341?
[CUSTOMER][NEUTRAL] OK. Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, that's not covered under this policy. Mhm.
[CUSTOMER][POSITIVE] Yeah, correct.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] And what was the other one?
[CUSTOMER][NEUTRAL] So is it more like a preventive plan?
[AGENT][NEUTRAL] Uh, this is only, it only has preventative and basic coverage. And again, all of the codes that are covered. Mhm. Yes, and that's the only services on this plan and it does give you that information on the fax back and then again, any code that's not listed means it would not be covered.
[CUSTOMER][NEUTRAL] Oh, preventative and basic.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, well that'll be easy then, um, so I don't need those questions and at all, um, for this plan, do you accept assignment of benefits to non-participating provider? We are a PPO provider so we do work.
[AGENT][NEUTRAL] Yes, this plan participate. Yes, OK, so this plan participates with the Carrington PPO network. however, they're not required to utilize a network provider.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh, OK, yeah, and then if benefits are exhausted, do you participating.
[AGENT][NEUTRAL] And that's stated on there as well.
[CUSTOMER][NEUTRAL] Oh, is it OK, um, and then if benefits are exhausted, do participating provider discounts apply?
[AGENT][NEGATIVE] There would be no coverage if the benefits are exhausted, not with APL.
[CUSTOMER][NEUTRAL] No, OK.
[CUSTOMER][NEUTRAL] OK, that makes sense. The other two are no then too, and then all I need is a reference number.
[AGENT][NEUTRAL] Sure, you would use my name that I gave you along with today's date and then [PII], one last thing, um, if you end up filing a claim with APO once it has been processed by us, we do have a portal in which you should be able to check claim status for this number and the website that you would go to for that is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect and then did you already happen to send that fax?
[AGENT][NEUTRAL] I did. Yes, ma'am.
[CUSTOMER][POSITIVE] Oh, awesome. All right. And then,
[AGENT][NEUTRAL] And I sent it to [PII].
[CUSTOMER][NEGATIVE] Oh sorry.
[CUSTOMER][POSITIVE] Yeah, perfect and I'm sorry, what was your name?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Alright perfect thank you so much for your help and have a great day.
[AGENT][POSITIVE] All right. Well, you're welcome. I hope you have a great day too. If that's all I can help you with, thank you again for calling APL.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Yes, ma'am.