AccountId: 011433970860
ContactId: 153f95d3-ca6d-41a3-8b29-5890d16cd56e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 654450 ms
Total Talk Time (AGENT): 372129 ms
Total Talk Time (CUSTOMER): 152926 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/153f95d3-ca6d-41a3-8b29-5890d16cd56e_20250402T14:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Yes ma'am, I'm trying to get uh uh see what all my benefits, my dental benefits are.
[AGENT][NEUTRAL] OK, you're needing information on your dental benefits, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes, sir, I can help
[CUSTOMER][NEUTRAL] On my end, uh.
[AGENT][NEUTRAL] Yes, sir. I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] Uh, my name is [PII].
[AGENT][POSITIVE] Thank you, and Mr. [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, and your policy number, please?
[CUSTOMER][NEUTRAL] It is 02504688.
[AGENT][NEUTRAL] OK, thank you. So give me a couple of moments please, Mr. [PII] to get your information pulled up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, Mr. [PII], I will need to verify several things with you first for security and also any information that I provide for you would 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] [PII].
[AGENT][POSITIVE] Thank you. Also your home mailing address?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And your
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is the same as the one you gave me, so again that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Thank you and lastly your email address.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] and all that is lower case.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] All right, thank you so much. So I do see that your policy is active with APO as of [PII].
[AGENT][NEUTRAL] And um, do you have specific questions on your benefits, Mr. [PII]? This plan, because this plan provides benefits for preventative and like X-rays and basic expenses and basic restorative. This plan you have does not cover any type of major services.
[CUSTOMER][NEUTRAL] OK, what about, does it cover extractions?
[AGENT][NEUTRAL] Um, this policy does have benefits for simple extractions. Yes, sir.
[CUSTOMER][NEUTRAL] OK, then by simple extraction, what do you mean by that?
[AGENT][NEUTRAL] Well, what I would recommend is that falls under an extraction of a, an erupted tooth or an exposed tooth. Uh, there's certain codes that are covered under your
[AGENT][NEUTRAL] Plan. Um, so this would fall under your basic category for that type of extraction.
[AGENT][NEUTRAL] Which would be subject to your $50 calendar year deductible and your benefit maximum on this plan is $500 per calendar year for covered outpatient services. So what I would recommend is to provide your information to your dental provider. They can call us to ask us specific questions on codes that they have.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That would be relevant to your treatment.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, so if they need it, if they like you said, like you just said, if they need to find out anything whenever I go down there to the dentist, I can just have them to call your call your office and they can get you can get OK.
[AGENT][POSITIVE] Absolutely, yeah.
[AGENT][NEUTRAL] Mhm, absolutely, most, most dental providers will do that anyway to call to verify your policy is active and then to ask us any questions on the benefit information that they're needing.
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. OK. And, OK, for, OK, they're dealing with distraction. Uh, let me ask you about was, uh, does it cover like any type thing like, uh, dentures or anything like that?
[AGENT][NEUTRAL] No, sir. You do not have any, um, let's see, I don't believe so. No, sir, that is not covered.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] OK, so that'll be out of pocket.
[AGENT][NEGATIVE] It would, yes, it would not be covered under this plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] So I've got, I have the.
[CUSTOMER][NEUTRAL] Uh, the, like I said, the traction up to cor on how bad the tooth is, right?
[AGENT][NEUTRAL] Correct. It would just depend, be dependent on the, yeah, uh, the extensiveness of it and the codes that they're, you know.
[AGENT][NEUTRAL] which they would be able to provide us that information.
[AGENT][POSITIVE] But for a simple extraction, yes, I did give you the benefits for what would be covered under this plan.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] OK, so could you give me, uh, all that, what it all it covers up under that plan.
[AGENT][NEUTRAL] Now I can what I'm gonna do Mr. [PII], have you ever set up your profile in our portal called the online service center?
[CUSTOMER][NEUTRAL] Uh, no, I don't think so.
[AGENT][NEUTRAL] OK, so I have a
[AGENT][NEUTRAL] User guide that I'm going to email you that will explain how to set up your profile and in your portal once you get that set up it has your ID cards, there is a copy of your policy information in there with all your benefits that you can view.
[AGENT][NEUTRAL] And you'll also be able to see claims that we receive on your, on your plan again for preventative expenses like your cleanings and that type of thing you have benefits for that.
[AGENT][NEUTRAL] For X-rays, for FMX expenses, and basic expenses, things that fall under the basic category and basic restorative, you do have benefits. But anything that's major like crowns, they're talking about the dentures, things like that, orthodontics, that is not covered.
[CUSTOMER][NEUTRAL] Well, let me ask you this, is there any way that I can get that insurance through y'all that covers all that?
[AGENT][NEUTRAL] Now if you, you would have to reach out to uh benefits in a card because that is the enrollment company that works with your employer for your benefits and then they provide APL with, you know, the enrollment information.
[AGENT][POSITIVE] So I'll be happy to give you their phone number. I can also connect you with one of their representatives and then they could tell you what is available you know to you what your different options are for your employer.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so, and let me ask you another question. What about, uh, that, that issues I was just asking about, about the dealing with the crowns and all that does that deal with paradontist, uh.
[AGENT][NEUTRAL] Again,
[CUSTOMER][NEUTRAL] Like the periodontal diseases.
[AGENT][NEUTRAL] Again, I don't know what your options are for your particular employer, you know, for who you work for, so that would be a question that benefits and a card would have to answer for you.
[AGENT][NEUTRAL] To let you know if there is a plan available to you that does have benefits for those types of services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't believe that there is one with APL that's available to your group, but again, they would need to verify that with you.
[CUSTOMER][NEUTRAL] OK then.
[AGENT][NEUTRAL] And would you like for me to give you their phone number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am, let me get that number and uh send me that uh whatever that was you gonna send me through the email.
[AGENT][NEUTRAL] Yes, so I'm gonna send you that user guide for how to set up your profile.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the phone number for benefits in a card regarding any enrollment or changes to your coverage, that phone number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So would you like for me to connect you with them or are you going to call them directly?
[AGENT][POSITIVE] I'll, I'll be happy to do either.
[CUSTOMER][NEUTRAL] Uh, just, I'll just talk.
[CUSTOMER][NEUTRAL] I'll call him directly.
[AGENT][NEUTRAL] OK. Well, all right then. Well, is there anything else that I could help you with today?
[CUSTOMER][NEUTRAL] Uh, no, ma'am, I'll just be waiting on that user package that you're gonna email me and I can look through it.
[AGENT][NEUTRAL] OK, yes, so well I will send that email to you in just a couple of moments and the email again it's gonna come from [PII] and I will put APO in your subject line so that that's easy to recognize.
[CUSTOMER][POSITIVE] OK, I greatly appreciate it.
[AGENT][POSITIVE] Well, you are certainly very welcome. So again, is there anything else I can help you with?
[CUSTOMER][POSITIVE] Um, no, that'll be all. I, I appreciate it.
[AGENT][POSITIVE] Well, you're certainly welcome, Mr. [PII]. It was my pleasure in helping you today, so thank you again for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] All right.
[AGENT][POSITIVE] Yes, sir. Thank you.
[CUSTOMER][NEUTRAL] You do that.
[CUSTOMER][NEUTRAL] Uh bye.
[AGENT][NEUTRAL] Ah, ba ba.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Oh.