AccountId: 011433970860
ContactId: ecec47b4-1af0-4845-b81b-2f1b3e81d25c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 296570 ms
Total Talk Time (AGENT): 146510 ms
Total Talk Time (CUSTOMER): 87381 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/ecec47b4-1af0-4845-b81b-2f1b3e81d25c_20250115T19:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from Phillips Family Dentistry. I'm calling from a provider's office and I've just never heard of American Public Life.
[CUSTOMER][NEUTRAL] Is this dental?
[AGENT][NEUTRAL] Uh, we offer several policies. Do you have a policy number?
[CUSTOMER][NEUTRAL] I do, yes ma'am. I've got a policy number and a group number. OK, policy number is.
[AGENT][NEUTRAL] OK, let me get that number.
[AGENT][NEUTRAL] Let me have the policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 02554433
[AGENT][NEUTRAL] OK. Spell your first name for me.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] OK, thank you, [PII] and what's a good phone number in case we're disconnected?
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh [PII], and her date of birth is a good question. I'm pulling it up. I'm sorry.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] You are, I'm, I'm multitasking.
[CUSTOMER][NEUTRAL] Date of birth is [PII]. I'm sorry.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So this is a dental policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, were you needing dentist?
[CUSTOMER][NEUTRAL] Do you guys use the 1.
[AGENT][NEUTRAL] For him.
[CUSTOMER][NEUTRAL] Yeah, connection connection fee schedule or the sunlight fee schedule or you?
[CUSTOMER][NEUTRAL] I don't know if you guys are in in network or out of network.
[AGENT][NEUTRAL] Uh, neither.
[AGENT][NEUTRAL] Yeah, there's actually not a network of contracted providers for this dental plan. They could choose a provider of their choice. um, this and the policy is based off of UCR, I believe. Let me pull up the schedule.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, so preventive is reimbursed at 100% of UCR basic 80, and then major is 40%. Um, there is a 12 month waiting period for all major services. Do you want the schedule of benefits faxed over to you, [PII]?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, what's that number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Preparing the document, should receive it within the next 5 minutes.
[AGENT][NEUTRAL] Policy has been effective since [PII]. Currently active.
[AGENT][NEUTRAL] OK, so we've faxed over the schedule. You should receive it just in a few minutes. Um, there's no history for the patient, um.
[AGENT][NEUTRAL] Let's see, the schedule is going to include the calendar year maximum which is $1500 per covered person. Uh there's a $50 per covered person deductible up to $150.
[AGENT][NEUTRAL] For the family?
[AGENT][NEUTRAL] This policy is for it's a family policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yeah, so this is a family policy. Um, I gave you the category expenses, um, prevented the 100 basic 80 major at 40 of UCR.
[AGENT][NEUTRAL] Uh, did you need the frequencies? This information is on the, the, uh, schedule of benefits that I'm sending that I sent to you.
[AGENT][NEUTRAL] Um, it outlines.
[CUSTOMER][NEUTRAL] If it's on the fax, that's fine.
[AGENT][NEUTRAL] Yeah, it outlines the exclusions under the plan, um, the claims payer ID mailing address and fax number and then it's about a total of perhaps 9 pages with the cover sheet, so it includes every code that's or each code that's covered under the plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you guys take electronic um submissions or is it paper mail? You do? OK, do you have and you said the payer ID is on there as well?
[AGENT][NEUTRAL] Mhm. We do. Mhm, yes, we do.
[AGENT][NEUTRAL] Yeah, the payer ID number is listed there.
[CUSTOMER][POSITIVE] OK, I should be good. I should be able to get everything I need off of there.
[AGENT][NEUTRAL] As well.
[AGENT][NEUTRAL] Yeah, very detailed the limitations are gonna be um on the very last page tells you which codes share frequencies, that type of information is on the bottom of the last page.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I appreciate your help.
[AGENT][POSITIVE] You're welcome, [PII]. Any other questions I could help out with today?
[CUSTOMER][NEUTRAL] No, ma'am, that's all.
[AGENT][POSITIVE] All right, thanks for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Thank you.