AccountId: 011433970860
ContactId: 02bd858a-6a18-44aa-acf3-446c451c124b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 670789 ms
Total Talk Time (AGENT): 373300 ms
Total Talk Time (CUSTOMER): 231947 ms
Interruptions: 3
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/02bd858a-6a18-44aa-acf3-446c451c124b_20250605T18:47_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Yes ma'am, how you doing?
[AGENT][POSITIVE] I'm great. How are you today?
[CUSTOMER][NEUTRAL] What information do you need so you can, oh, pretty good, pretty good, uh, what, what information do you need so you can pull up my account?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you're the insured. Is that correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK. Yes, sir. Well, first off, who am I speaking with?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] No, no, no, no, [PII].
[AGENT][POSITIVE] [PII]? OK, I'm so sorry.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, callback number is [PII].
[AGENT][NEUTRAL] And Enrique
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, and your policy number?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] I don't know what that is. I just have a member ID. Is that that work?
[CUSTOMER][NEUTRAL] A member member number.
[AGENT][NEUTRAL] Is that what's on your
[AGENT][NEUTRAL] You can give me that number.
[CUSTOMER][NEUTRAL] I have a group number, a group affiliate.
[CUSTOMER][NEUTRAL] I have a member number. What do you need?
[AGENT][NEUTRAL] Uh, you can try and give me the member number.
[CUSTOMER][NEUTRAL] OK, 02.
[CUSTOMER][NEUTRAL] 356 257.
[AGENT][NEUTRAL] Alright, thank you. One moment. Let me see if I can pull your information up.
[AGENT][NEUTRAL] OK, so first off, how can I, while your information is pulling up, how can I help you today, [PII]?
[CUSTOMER][NEUTRAL] OK, cause I went to the dentist. OK, well, let's start off with this. I wanna say I've had this insurance for about 3 years.
[CUSTOMER][NEUTRAL] Right?
[CUSTOMER][NEUTRAL] Maybe going on 4.
[AGENT][NEUTRAL] Well, I
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, uh,
[CUSTOMER][NEUTRAL] I've never ever used this insurance.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Now, I went to the dentist.
[CUSTOMER][NEUTRAL] And there's, and I needed some deep cleaning, some extracts, uh, uh, a couple of other stuff, right? And they told me that some of the stuff.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] There's a waiting period so [PII].
[CUSTOMER][NEGATIVE] And I said, I've never, I've had the insurance for almost 3 years, almost 4. I wanna say, I've never used it. I don't see why there's a waiting period if I've never even used it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you have some questions on your dental policy. Is that right?
[CUSTOMER][POSITIVE] Yes ma'am, yes ma'am.
[AGENT][NEUTRAL] OK, yes, so I can help you and but first off I'll need to verify some information with you for security purposes and then also any information that I do provide for you, Mr. [PII] will be a verification of benefits and not a guarantee of payment. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And then also your home mailing address.
[CUSTOMER][NEUTRAL] Uh, I don't even know what what we have it. Oh, it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you and then your phone number that is on file is the same as the one you gave me, so that is your best contact number that we should have. OK, thank you and the last piece of information to verify is going to be your email address.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, Mr. [PII], thank you for verifying your information. So first off, the policy number that you gave me, that was your medical policy number, not your dental.
[AGENT][NEUTRAL] I can give you your dental number, but it is different. If you want to write it down.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, OK, I got let me put up my notes on my phone.
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] Uh and uh.
[CUSTOMER][NEUTRAL] Uh, OK, what is it?
[AGENT][NEUTRAL] OK, so your dental policy number is 235.
[AGENT][NEUTRAL] 62.
[CUSTOMER][NEUTRAL] Let's see it's 2 hold on 235.
[AGENT][NEUTRAL] Uh-huh. No, no, no. OK, so I'm gonna start over. I'm gonna start from the very beginning. 235.
[CUSTOMER][NEUTRAL] 16
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] I'm sorry, I'm driving. OK, 235.
[AGENT][NEUTRAL] That's OK. Well, well, I want you to be safe. 6.
[AGENT][NEUTRAL] 2
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] 09.
[CUSTOMER][NEUTRAL] 092356209.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes sir, that is correct. And this policy, yes, that's your dental policy number. Now, have you ever set up your profile in the past with APL so that you can have access, Mr. [PII], to your information regarding your policy with APL online?
[CUSTOMER][NEUTRAL] Right?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I believe I did maybe about
[CUSTOMER][NEUTRAL] Couple of months ago, back in maybe September, but I don't remember like what I did.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well that's fine. So what I'm gonna there was recently been an update to the portal so even if you had set it up before you have to do a new profile so I will email you the user guide on that so again you're just gonna when you go to the.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Initial page you're gonna follow the instructions to just set up an entirely new profile, OK?
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Alright, so on your you have had this policy. Well, let me go ahead and tell you about the email that I'm gonna send you the email that I will send to you is going to come from [PII], [PII] uh huh, and I will put [PII] in your subject line.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that that's easy to recognize. Now, I don't think that it will go to your junk or spam folder, but in the event that you have not seen that in your regular inbox, you know, within a few minutes of our call being finished, then I would check your junk or spam folder just to see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] OK. All right. So now you have had your dental policy with us for several years. This policy went into effect [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So your waiting periods, you do have a twelve-month waiting period on certain categories, but that waiting period has
[AGENT][NEUTRAL] That ended as of [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So I'm not
[AGENT][NEUTRAL] I, I don't under, you know, I'm not sure about why they told you that.
[CUSTOMER][NEUTRAL] Yeah, OK. I, I don't know because it had.
[CUSTOMER][NEGATIVE] Uh, you know, the extractions and this and that, whatever, and they're like, well, you know, it's not covered. There's a waiting period. I said, I mean, I've had the insurance for a while. I don't believe there should be a waiting period.
[CUSTOMER][NEUTRAL] So they're telling me that you guys are telling them that, so I mean I'm just kinda in the middle, you know what I mean?
[AGENT][NEUTRAL] Yes, sir, and I can see that um that someone from our provider's office, let me, let, give me just a moment to look at a couple of things, if you don't mind.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I'm not sure. I can see that someone
[AGENT][NEUTRAL] By the name of [PII] with a provider's office, call to get benefits and eligibility on you today. Do you know who she is?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Today
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Today?
[AGENT][NEUTRAL] Today.
[CUSTOMER][NEUTRAL] I mean, I spoke to somebody right now, but I don't think she called.
[AGENT][NEUTRAL] OK, someone
[AGENT][NEUTRAL] Call today to get eligibility and benefits so I'm not sure if there was a miscommunication in the information.
[AGENT][NEUTRAL] That she, you know, received.
[CUSTOMER][NEUTRAL] Did, did [PII], you said, did she call from, from [PII]?
[AGENT][NEUTRAL] Um, I can, mm, well, I can't see the, well, let me see if the, the number that, give me just a, just please bear with me while I'm just looking up something.
[CUSTOMER][NEUTRAL] Do you, do you happen to know?
[CUSTOMER][NEUTRAL] And does it tell you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Yes. I, I searched the phone number that we show called and yes, that is with [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Uh huh, yeah, yes ma'am.
[AGENT][NEUTRAL] Yes. So I'm not sure if there was some type of miscommunication or she misunderstood what your effective date on the plan was.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, but this policy went into effect [PII].
[CUSTOMER][NEUTRAL] [PII] OK.
[AGENT][NEUTRAL] And all
[AGENT][NEUTRAL] Yes, sir. And we don't have.
[CUSTOMER][NEUTRAL] All waiting period was of [PII].
[AGENT][POSITIVE] Correct. You do, you know, the 12-month waiting period was satisfied.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] After [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so then there should be no waiting period or none of that, right?
[AGENT][POSITIVE] Correct. That has been, yes.
[AGENT][NEUTRAL] Your waiting period has been met.
[CUSTOMER][NEGATIVE] OK, alright, let me call them let me call them because they're giving me a completely different price with, with, uh, astronomical price with the waiting period and I don't know what and uh a whole bunch of seems like they don't even know what they're doing.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] But let me call them and yeah, that's why I was like wait a minute, there shouldn't be no waiting period. I've had it for a while, so, you know, let me call them back and have this straight now.
[AGENT][NEUTRAL] OK, well, if they have any other questions, you know, have them to give us a call again. Like I said, I don't know if there was a miscommunication or, you know, between your effective date. I, I, I honestly, I can't say. All I can tell you is your policy is, is active, your waiting period has been satisfied and um.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][POSITIVE] You know, your policy's been in effect since [PII]. OK. OK. Well, if I, is there anything else I can help you with? You're welcome, Mr. [PII]. Can I help you with anything else? Well, then, thank you for calling APL and I hope you have a nice and safe afternoon.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] It's good, it's good, it's good to go basically.
[CUSTOMER][POSITIVE] Yes ma'am, thank you ma'am.
[CUSTOMER][NEUTRAL] That'd be all, ma'am.
[CUSTOMER][NEUTRAL] That'd be all, ma'am.
[CUSTOMER][NEUTRAL] So I
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.