AccountId: 011433970860
ContactId: f92118dd-0f4c-48ad-b92f-ad9808eb315f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316359 ms
Total Talk Time (AGENT): 149942 ms
Total Talk Time (CUSTOMER): 145184 ms
Interruptions: 2
Overall Sentiment: AGENT=1.8, CUSTOMER=2.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/f92118dd-0f4c-48ad-b92f-ad9808eb315f_20250117T14:29_UTC.wav
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[AGENT][POSITIVE] Good Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi there, um, I'm calling from a provider's office and I was hoping to verify um benefits and eligibility.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you. May I ask your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you [PII] and what is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number?
[CUSTOMER][NEUTRAL] I have 02564938.
[AGENT][NEUTRAL] And [PII], what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yep, his name is [PII]. Date of birth.
[CUSTOMER][NEUTRAL] Just a sec.
[CUSTOMER][NEUTRAL] I have [PII].
[AGENT][NEUTRAL] All right, thank you. And this is for dental eligibility?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, thank you, and I can help you with that. I am showing that [PII]'s policy is active. Effective date is [PII]. I'm yeah, that's right. I'm sorry, 11-11-24.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And um let's see here, are you able to look I I feel like we're out of network, but can we double check that?
[AGENT][NEUTRAL] The policy participates in the Carrington PPO network, however, for uh network participation is not required for benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got you. OK, so they do pay out of network, uh, is that what you're saying? OK, perfect.
[AGENT][NEUTRAL] We do. Yes, ma'am.
[CUSTOMER][NEUTRAL] Alright, does this policy run on a calendar year or a contract year?
[AGENT][NEUTRAL] It is a calendar year.
[CUSTOMER][POSITIVE] Perfect and um.
[CUSTOMER][NEUTRAL] What is the yearly maximum?
[AGENT][NEUTRAL] I tell you what, I've got a fax back I can send you with the calendar year max deductibles, frequencies, limitations, and billing information if you're interested.
[CUSTOMER][POSITIVE] That would be beautiful.
[AGENT][POSITIVE] I'm working on that for you right now. And [PII], do you, how do you spell your name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Oh, you spelled the right way. Good deal.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] It's funny, I get that a lot, yeah.
[AGENT][NEUTRAL] You never know.
[AGENT][NEUTRAL] You never know.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, traditional.
[AGENT][POSITIVE] I like it.
[AGENT][NEGATIVE] I feel like we have complicated things so much.
[CUSTOMER][NEUTRAL] I say that every day working in this field, seeing all different kinds of spellings of names. I'm like, why did we do that?
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] Well, what is that fax number?
[CUSTOMER][POSITIVE] That's funny.
[CUSTOMER][NEUTRAL] Of course it's gonna be [PII] no hang on [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And just to verify that fax number, I'm sending this to [PII]. Is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, so that is on the way for you.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] I would say this is a limited dental policy. It does not cover major procedures.
[CUSTOMER][NEUTRAL] OK, that's good to know, no major.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then um.
[CUSTOMER][NEUTRAL] Let me see, will it have any waiting periods?
[AGENT][NEUTRAL] There's no waiting period. It
[AGENT][NEUTRAL] Um, will not have the group name and number listed if you need that, I can provide that for you as well.
[CUSTOMER][NEUTRAL] OK, I'm looking at his card. I have a group number of 70087.
[AGENT][NEUTRAL] That's correct and the group name is Partners Personnel Management Services.
[CUSTOMER][NEUTRAL] Partners.
[CUSTOMER][NEUTRAL] Personnel management services.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] services OK and you said so it should have percentages and frequencies, no major, um, so it'll list what um basic it is covered on the tax back.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's correct. So your preventive is covered at 100% and basic at 80.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, alright, well I'll have a look at it and if I have any more questions I can always call back. You guys are pretty easy to get through, so not bad. I love it.
[AGENT][NEUTRAL] Yeah, don't you like that?
[AGENT][POSITIVE] We try, we try to, we try to make it easy on everybody.
[CUSTOMER][POSITIVE] I really do love it. All right. And what was your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][POSITIVE] And [PII], it's been a pleasure to assist you with that breakdown for Mr. [PII]. Is there anything else I can help you with today? Oh, he has no history.
[CUSTOMER][POSITIVE] No history perfect yeah thank you so much. I appreciate you.
[AGENT][NEUTRAL] You might wanna know that.
[AGENT][POSITIVE] It's been my pleasure, [PII]. Thank you for calling APL. I hope you have a very happy weekend.
[CUSTOMER][POSITIVE] Thanks you too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.