AccountId: 011433970860
ContactId: f8f1ad75-d005-4303-aa4f-4095667f6ee7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 452239 ms
Total Talk Time (AGENT): 134569 ms
Total Talk Time (CUSTOMER): 193002 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/f8f1ad75-d005-4303-aa4f-4095667f6ee7_20250609T16:55_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I am looking for um dental benefit verification for a patient.
[AGENT][POSITIVE] OK, [PII], I can help you with dental benefits. Do you have a good callback number?
[CUSTOMER][NEUTRAL] I do it's [PII].
[AGENT][NEUTRAL] OK, thank you. And the policy number for that patient?
[CUSTOMER][NEUTRAL] 483-941-96
[AGENT][NEUTRAL] Uh, what was the first and last name?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Should be [PII].
[AGENT][NEUTRAL] [PII] and then [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Give me just one moment.
[AGENT][NEUTRAL] And you have the date of birth?
[CUSTOMER][NEUTRAL] I do. It is [PII].
[AGENT][NEUTRAL] Um, let me give you the correct policy number. It's 255.
[AGENT][NEUTRAL] 0437.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. That's what I gave the other gal.
[AGENT][NEUTRAL] Uh, I've got
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] And she gave me a, OK, so that must be the dental and then the one she gave me must be medical.
[AGENT][NEUTRAL] Uh, what's the other one that you received?
[CUSTOMER][NEUTRAL] So the the other one was [PII].
[CUSTOMER][NEUTRAL] And the one you gave me was the one that he gave us.
[AGENT][NEUTRAL] Yeah, um, there.
[AGENT][NEUTRAL] The insurance is through a temp agency, so there's a lot of different little policies that are part of this um.
[AGENT][NEUTRAL] That they offer their employees. So but this one that I gave you, that's the one. And then do you want me to send you over a fax back that outlines all what's covered under the policy frequency duration and then the codes that are covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes. Oh, that would be.
[CUSTOMER][POSITIVE] Yes, that would be wonderful.
[AGENT][NEUTRAL] OK, what's your facts [PII]?
[CUSTOMER][NEUTRAL] It's gonna be 833.
[CUSTOMER][NEUTRAL] 4781405
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And do you know if the doctor would be in network with this plan?
[AGENT][NEUTRAL] Um, so they do, they can go in or out of network because they don't have to utilize the network. They can use Carrington if they like. I don't know if you're in network with Carrington, but I can, um, give you the number to check with them.
[CUSTOMER][POSITIVE] Sure, that would be great.
[AGENT][NEUTRAL] Um, so Carrington's number is [PII].
[AGENT][POSITIVE] [PII]. Um, I can, I'm happy to transfer you over there too if you like.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Oh no that's OK. I'll call them back when I get this form filled out um just a couple questions on the plan before I let you go um you said what, what was the name of the insurance company? I is it Carrington or is it a different dental company?
[AGENT][NEUTRAL] Um, it's American Public Life.
[CUSTOMER][NEUTRAL] OK, and then the phone number that I called actually transferred me to you so is there a different phone number that I should call to get directly through to American Public Life?
[AGENT][NEUTRAL] Yes, our number is [PII].
[CUSTOMER][NEUTRAL] Thank you. And is there a KRAD and claims address that will be on the fax or should I get that from you?
[AGENT][NEUTRAL] Yes, it'll be on the fax. We've got fax number, payer ID, and our claims address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then timely filing for the plan?
[AGENT][NEGATIVE] Uh, there's no timely filing.
[CUSTOMER][NEUTRAL] None. OK, perfect. And do you know what the effective date for Mr. [PII] is?
[AGENT][NEUTRAL] Effective [PII] 24 policies active.
[CUSTOMER][NEUTRAL] OK, and then does he have any history because this would be a new plan for him. He prior to this we verified a you a signal plan so wanna make sure.
[AGENT][NEGATIVE] Uh, he does not have any history at all.
[CUSTOMER][NEUTRAL] And then um.
[CUSTOMER][NEUTRAL] Let's see
[CUSTOMER][NEUTRAL] For the dental codes, is everything covered or is it just a certain amount of codes that will be on the fax? I mean, I, I should ask if if all the codes covered will be on the fax or if there are some missing.
[AGENT][NEUTRAL] Um, all the codes covered will be on the fax. It's a pretty limited policy. It doesn't have any major coverage, so that's not a guarantee of payment, just a basic outline.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. And then is there any coordination of benefits that is allowed like normally on these plans? Standard, not duplicate?
[AGENT][NEUTRAL] Yeah, it's just
[AGENT][NEUTRAL] Standard
[CUSTOMER][NEUTRAL] OK, perfect. And lastly, any downgrades well I assume if it doesn't have major, but it is uh are the fillings covered at all on this plan?
[AGENT][POSITIVE] Uh, yes, there's some coverage for that. Um, there's no downgrades.
[CUSTOMER][NEUTRAL] OK perfect and is there uh uh will the frequencies be listed as well as shared um frequencies?
[AGENT][NEUTRAL] Yes, there'll be a key um at the end of the list of codes that will the frequencies are at the first page and then the key is at the end of the codes that shows um the definitions.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome and then you said there's no major coverage so that would mean no crowns and no prosthetics.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK perfect so I don't need to worry about Pedro on prep seat date.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK perfect and then I assume that means no no implants as well and any major services associated with implants perfect and then um lastly I guess oh where did I see that um.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I guess that's it, um.
[CUSTOMER][POSITIVE] Thank you so much for your help, [PII]. Is there a reference number for our call?
[AGENT][NEUTRAL] A reference number is just my name, [PII], first initial to last name, [PII], and today's date, and I'll get that faxed your way. It just takes a few minutes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect thank you so much. I'll call back if I don't get it within the next hour.
[AGENT][POSITIVE] OK, thank you so much. Thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thanks.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Uh huh bye bye.