AccountId: 011433970860
ContactId: fd138789-75d5-4662-a79e-54d24d05465b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 345589 ms
Total Talk Time (AGENT): 122001 ms
Total Talk Time (CUSTOMER): 109558 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/fd138789-75d5-4662-a79e-54d24d05465b_20250618T15:41_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, good morning. My name is [PII] and I'm calling from North Springs Dental. Another patient coming in that just gave me um your name and phone number as their dental insurance, so I'm trying to get a breakdown.
[AGENT][NEUTRAL] OK, well, I can help you with the eligibility and provide a fax back if needed. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have the policy number?
[CUSTOMER][NEUTRAL] I have his social.
[AGENT][NEUTRAL] OK, that's fine.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] So I'm just waiting for the policies to come up here. And can you verify the member's first and last name?
[CUSTOMER][NEUTRAL] Um, the insured is [PII] 8-31-84 is the date of birth.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm calling on his daughter, [PII].
[AGENT][NEUTRAL] So I believe I just located the policy. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Hers is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So the policy number is 263.
[CUSTOMER][NEUTRAL] 01 minute, 263.
[AGENT][NEUTRAL] 5445.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, is there a group number too?
[AGENT][NEUTRAL] And the
[AGENT][NEUTRAL] Yes, the group number is 70102.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the policy has been affected, go ahead.
[CUSTOMER][NEUTRAL] And it
[CUSTOMER][NEUTRAL] No, go ahead.
[AGENT][NEUTRAL] The policy has been effective since [PII].
[AGENT][NEUTRAL] Did you need the group name as well?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] It's Cornerstone Staffing.
[AGENT][NEUTRAL] Solutions
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. And um, do they have waiting periods or missing tooth cloths?
[AGENT][NEUTRAL] Um, hold on one moment, I'm pulling the facts back now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so there's no waiting period. This policy does not cover any major expenses. Major for us is endodontic, periodontic, prosodontic, and oral surgery.
[CUSTOMER][NEUTRAL] Endopperio and oral surgery is not covered.
[AGENT][NEUTRAL] And proso on it.
[CUSTOMER][NEUTRAL] The no major.
[CUSTOMER][NEUTRAL] Benefits, so, um, or it's not covered either.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] I'm sorry, one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Just get on on Spring. How may I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] We are, yes ma'am. Did you wanna get on the schedule?
[CUSTOMER][NEUTRAL] OK, do you mind if I place you on a brief hold?
[CUSTOMER][POSITIVE] I'm sorry about that.
[AGENT][NEUTRAL] Oh, that's OK.
[AGENT][NEUTRAL] And what's a good fax number for?
[CUSTOMER][NEUTRAL] OK, so no waiting periods now. I'm sorry, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's
[CUSTOMER][NEUTRAL] And I'm sorry, what was your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][POSITIVE] [PII], thank you.
[AGENT][NEUTRAL] You're welcome. And that was [PII].
[CUSTOMER][NEUTRAL] Uh, there's no attention. I'll get it. Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And did you have any other questions?
[CUSTOMER][NEUTRAL] Um, so crowns are not covered, I take it. Um, can you tell me the age for fluoride and silents?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, so hold on one second.
[AGENT][NEUTRAL] So limited to dependent children under age [PII]?
[AGENT][NEUTRAL] That's for both.
[AGENT][NEUTRAL] The fluoride and the sealants.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then it'll give me deductibles, max, and all that and the mailing address and do you know which fee schedule I use?
[AGENT][NEUTRAL] Yes, you'll see the
[AGENT][NEUTRAL] It's a standard Carrington fee schedule. On the fax back, you'll see the calendar year max, deductible, all the percentages, the frequencies, the exclusions, all the ways to file a claim, and there's a list of covered codes. If the code you're looking for is not on this list, it wouldn't be covered by the policy.
[CUSTOMER][POSITIVE] OK perfect and so.
[CUSTOMER][NEUTRAL] Alright, perfect. And then the address for the claims is on there as well and the payer ID.
[AGENT][NEUTRAL] Yes, the address, pay ID, and fax number.
[CUSTOMER][POSITIVE] OK perfect thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] No, that's it thank you.
[AGENT][POSITIVE] All right, thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye.