AccountId: 011433970860
ContactId: 19cc0918-3c07-4149-9318-095f78e2a575
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 996419 ms
Total Talk Time (AGENT): 536314 ms
Total Talk Time (CUSTOMER): 399755 ms
Interruptions: 11
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/19cc0918-3c07-4149-9318-095f78e2a575_20250402T18:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. This is [PII], and I'm trying to, I have a basic plan. My claim, uh, let's see what my number is, um, check check policy policy number is 00613483.
[AGENT][POSITIVE] OK, thank you, Ms. [PII], go ahead and give me a good callback number for you just in case we were to get disconnected, I could call you back.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh sure, it's [PII].
[AGENT][NEUTRAL] OK. And so how can I help you today, Ms. [PII], while I'm getting your information pulled up?
[CUSTOMER][NEUTRAL] OK, I have a basic plan and I'm wondering if you have a premium plan that I don't have to wait since I've been with y'all 33 years.
[AGENT][NEUTRAL] OK, so you're wanting to find out if you could possibly upgrade your plan that you have, is that correct? Ms. [PII]? OK. Yes, ma'am. I'll be, I'll be able to help you with that. First, I will need to verify your information for security purposes. So first off, if you could please verify your date of birth for me.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Certainly, it's [PII].
[AGENT][POSITIVE] Thank you and also your home mailing address, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and your zip code please ma'am?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is the same as the one that you gave me, so that is your best contact number that we should have. Is that correct, Miss [PII]?
[CUSTOMER][NEUTRAL] Yeah, I have any other, uh, I don't have a home phone. This is my cell phone that's all I have.
[AGENT][NEUTRAL] OK, that's what most of us have these days. It's just we no longer have our landlines. Very few people do.
[CUSTOMER][NEUTRAL] I love and I love my landline. I wish I could have it back.
[AGENT][NEUTRAL] Ah.
[AGENT][NEUTRAL] I understand. Me too, Ms. [PII]. I, I wish I could do. And then the last thing is I see that we do not have an email address on file for you. Uh, do you use email very much or get on the internet much?
[CUSTOMER][NEUTRAL] Not much, but I, I'll give it to you if you want it. I don't know if I'll receive it, but
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well, I can add it.
[CUSTOMER][NEUTRAL] It's um.
[CUSTOMER][NEUTRAL] You're ready? Beer, it's [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. All right, so it's [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Uh, that's correct. Are you in [PII]?
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] No, ma'am, I'm actually in [PII].
[CUSTOMER][NEUTRAL] Oh great. Well then, you know what a beignet is, huh?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] I absolutely do. And based on your accent, are you from down there?
[CUSTOMER][POSITIVE] I love them.
[AGENT][NEUTRAL] Are you originally from [PII]? Yeah.
[CUSTOMER][NEUTRAL] I'm from [PII] originally, but I, but I, yeah, but I do, but I do live in [PII] now.
[AGENT][POSITIVE] Yes, that's it. Yes, ma'am. But I could tell by your accent. You certainly sounded like, um, that you could have been from down there. Yes, ma'am. Cafe Duon is one of my favorites.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh, well, that's what I.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] I don't think I've ever been to that city for any reason without going there, as a matter of fact. No matter what it was for, I don't think I've ever been to [PII] without going to Cafe Du Mont ever.
[CUSTOMER][POSITIVE] I love
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Well, I, I know, but they have some cafe Dumans they put out in the um like in May in different areas because I'm old.
[AGENT][NEUTRAL] Oh, have they, really?
[CUSTOMER][NEUTRAL] Yeah, I'm old and um you wouldn't want to go by yourself.
[AGENT][NEUTRAL] No, you wouldn't. No, no, ma'am.
[CUSTOMER][NEUTRAL] To [PII] nowadays. Now, I could walk up and down when I was young, you know, up and down and uh everybody knew everybody and we were all safe, but I, I don't know, I just wouldn't do it nowadays.
[AGENT][NEUTRAL] It's, uh, no, ma'am. I, I would not either. And, um, again, that used to be one of my favorite cities. I love the food, just the culture, but um as far as going down there with even just
[CUSTOMER][NEUTRAL] It's
[AGENT][NEUTRAL] A friend or my daughter or something? No, I would not.
[AGENT][NEGATIVE] Sad, but
[CUSTOMER][NEGATIVE] Oh, and I don't blame you because changed too much. I don't even recognize my hometown anymore.
[AGENT][NEUTRAL] Sure. I, I totally understand. Um, OK, so on your policy, Ms. [PII], um, unfortunately, no, ma'am. There is no way to upgrade through this.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, hang on just a minute, my dog's barking stop barking.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, no, what I was saying is, no, ma'am, there's not a way to upgrade on this type of policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. I
[AGENT][NEUTRAL] This, this is the only plan option available.
[CUSTOMER][NEUTRAL] So what do you suggest
[CUSTOMER][NEGATIVE] Uh, nothing's available for upgrade.
[AGENT][POSITIVE] Correct, right.
[CUSTOMER][NEGATIVE] Hm, and why don't y'all offer that? I didn't know this all these years ago, otherwise I'd have changed a long time ago. But I thought I could upgrade without a 6 month waiting period or a 3 month waiting period because y'all cover so little.
[AGENT][NEUTRAL] Right, because.
[AGENT][NEUTRAL] We know.
[AGENT][NEUTRAL] Yes, ma'am. Well,
[AGENT][NEUTRAL] Right, um,
[AGENT][NEUTRAL] On this policy, yes, ma'am. We, a long time ago, because you have had this policy for a long time, I see that. Um, at that time that we did sell individual policies, but now everything is strictly on a group level.
[CUSTOMER][NEUTRAL] And I
[AGENT][NEUTRAL] You know, an employer has to offer the, you know, coverage as a benefit in order to be able to enroll. So therefore, there's not any upgrades on this type of plan that you have or have.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] It's such a, a poor, and I didn't realize this until I had to have some, I got an abscess and had to have some extensive work in my mouth and it didn't cover, but $41 and that's ridiculous when the bill was over $3000.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Oh my gosh, yes, ma'am. Well, I'm sorry about that. I, I understand, but unfortunately, there's not a way to upgrade.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] 00.
[CUSTOMER][NEUTRAL] Uh-huh. Well, what, what could you tell me what would be uh covered if I got a bridge?
[AGENT][NEUTRAL] OK, so for any benefit information, um.
[AGENT][NEUTRAL] That would be anything that I tell you would be a verification of benefits and not a guarantee of payment. Give me just a moment to like pull your benefit information up.
[CUSTOMER][POSITIVE] OK, great.
[AGENT][NEUTRAL] OK. And you did say a bridge, did you say a bridge, Ms. [PII]?
[CUSTOMER][POSITIVE] Yeah, it'd be it'd be it'd be a crown and a permanent bridge.
[AGENT][NEUTRAL] OK, so on your, OK, so on your policy for crowns and bridges, that's once every 5 years.
[CUSTOMER][NEUTRAL] Together.
[AGENT][NEUTRAL] And depending, it would be dependent upon the code as far as because your policy has like set benefit amounts for your procedures that are covered.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] So that would, unless you have the code, it's gonna be really hard for me to like tell you specifically, right.
[CUSTOMER][NEUTRAL] Hard, oh.
[AGENT][NEUTRAL] Um, I would need the code from the, your dental provider.
[CUSTOMER][NEUTRAL] Yeah. So you, you said a
[CUSTOMER][NEUTRAL] OK, I haven't called them yet, but the crown.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You said a crowns every 5 years?
[AGENT][POSITIVE] A crown and bridge, yes, ma'am. That is once every 5 years that you're eligible for that.
[CUSTOMER][NEUTRAL] Well, I
[CUSTOMER][NEUTRAL] Well, I've never had a bridge, so what would that cover? Do you know?
[AGENT][NEUTRAL] Well, again, you know, you would be eligible if you've never had one before, but as far as me being able to tell you like what the benefit amount is for, for those procedures, I would really need the code because there's a lot of different codes that could potentially be used and like with spacers and, and just there's a lot of um
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] A lot of things involved in that and without the code I wouldn't want to tell you that it pays $350 when it actually may only pay, you know.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] $200.
[CUSTOMER][NEUTRAL] I'm, it pays what now? 3, 350?
[AGENT][NEUTRAL] No, I'm just saying, well, it, it, again, that depends. No, what I was saying, yes, it just depends the maximum, you know, on the codes. Again, it's really hard for me to tell you what it would cost. I was just throwing that number out there as an example.
[CUSTOMER][NEUTRAL] Approximately
[CUSTOMER][NEUTRAL] Do you know what I have left for um.
[AGENT][NEUTRAL] For this year.
[CUSTOMER][NEUTRAL] For, um, claiming at this point.
[AGENT][POSITIVE] Uh, let's see, sure, I can check that for you.
[CUSTOMER][NEUTRAL] For this year.
[AGENT][NEUTRAL] OK, so according to the records as of now for this calendar year, uh, you have.
[AGENT][NEUTRAL] Let's see, just one.
[AGENT][NEUTRAL] You still have a remaining $951.
[AGENT][NEUTRAL] Available of your $1000.
[CUSTOMER][NEUTRAL] Would you repeat
[AGENT][NEUTRAL] Yes, ma'am. You're.
[CUSTOMER][NEUTRAL] Would, would you, would you repeat that? How much? I didn't catch it.
[AGENT][NEUTRAL] Yes, ma'am, your calendar, your uh your calendar year maximum benefit is $1000.
[AGENT][NEUTRAL] And as of now you still have a remaining $951.
[AGENT][NEUTRAL] Available for you to use.
[CUSTOMER][NEUTRAL] OK, and it would all depend on the code they use.
[AGENT][NEUTRAL] Um,
[AGENT][POSITIVE] Correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] Mm mhm.
[AGENT][NEUTRAL] And then it shows you have used.
[CUSTOMER][NEUTRAL] And that could be a
[AGENT][NEUTRAL] $50 I mean $49 of your calendar year deductible.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You so you still have a $1 to make on that.
[CUSTOMER][NEUTRAL] And so could that, could that possibly if the right code was uh accessed, could that possibly cover.
[CUSTOMER][NEUTRAL] The crown
[AGENT][NEUTRAL] Uh, yes, ma'am, because you do have benefits for such things on your policy and you have up to a $951 balance as of now available.
[CUSTOMER][NEUTRAL] OK. Is there a certain code the dentist should use for this?
[AGENT][NEUTRAL] No, we can't tell them how to cut, yes, ma'am, no, they, they have all of that information. And again, depending upon what all they're gonna have to do, you know, they're
[CUSTOMER][NEUTRAL] For a bridge
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I know. That's terrible, huh?
[AGENT][NEUTRAL] Maybe multiple codes that have to be used.
[AGENT][NEUTRAL] Mhm. So.
[CUSTOMER][NEUTRAL] OK, well, I'll, I'll see what he has to say and um.
[CUSTOMER][NEUTRAL] I went to a second opinion and they said a uh
[AGENT][NEUTRAL] And you may just want to have to.
[CUSTOMER][NEUTRAL] Ma'am.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Mhm. No, go ahead. You want to have a second?
[CUSTOMER][NEUTRAL] I went and had a second opinion and um for the bridge, they would have to crown one tooth and get up and seem at a permanent bridging.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So that doesn't sound like it's gonna cover very much, does it?
[CUSTOMER][NEGATIVE] I don't think it will.
[AGENT][NEGATIVE] Uh, again, that's just really hard.
[CUSTOMER][NEUTRAL] But that's what the second opinion.
[CUSTOMER][NEUTRAL] I know, it all depends on the codes, and I hope they sure use the right codes when I go.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] But I do appreciate it and I'm
[AGENT][POSITIVE] Yes, ma'am. I can relate to that as well.
[CUSTOMER][NEGATIVE] Uh no.
[CUSTOMER][NEUTRAL] I'm telling you, I'm so surprised because um I didn't know y'all didn't upgrade and I did call a lot of dental plans and they all have the waiting period and I said, well, let me try my.
[CUSTOMER][NEUTRAL] Policy and see if y'all have an upgrade without a waiting period since I've been so long with y'all.
[CUSTOMER][NEGATIVE] But that's not possible.
[AGENT][NEUTRAL] Right. Yes, ma'am. I.
[AGENT][NEUTRAL] No, it's not, unfortunately, and I'm sorry about that.
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEUTRAL] That's OK. Well, I may take one step at a time. Thank you, and, and the year starts in January again, huh?
[AGENT][NEUTRAL] Yes, ma'am. That is correct. It's on your calendar, it is a calendar year plan.
[CUSTOMER][POSITIVE] OK, well I do appreciate you helping me and giving me the information I needed.
[AGENT][NEUTRAL] Well, oh, well, you're very welcome. And one last thing, Ms. [PII], since you gave me your email address and you do get online a little bit, we have a portal now for our members where you can set up your profile and, and you could log in to have access to your policy information online. If you think that's something that you would be interested in, yeah, I will.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, I don't. How do you get it?
[CUSTOMER][NEUTRAL] How do
[CUSTOMER][NEUTRAL] I'm sorry, I don't know how to get that though.
[AGENT][NEUTRAL] I'll email you the user guide with the instructions.
[AGENT][NEUTRAL] What, do you know how to check your email?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][POSITIVE] Yes, I do.
[CUSTOMER][NEUTRAL] You can send me a link.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, I will send you an email that gives you the link for the website that you would go to and then I'm gonna attach the instructions for how to go about setting that up.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And I'll email you. I'll go ahead. You're welcome. I'll email you that in just a moment. The email to uh Ms. [PII] that you will receive, it's going to come from [PII].
[CUSTOMER][POSITIVE] I appreciate that.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And I will put a.
[CUSTOMER][NEUTRAL] What I'm sorry, spell that for me clarity.
[CUSTOMER][NEUTRAL] I'm sorry, I didn't catch where it's coming from.
[AGENT][NEUTRAL] No, ma'am, [PII].
[AGENT][NEUTRAL] OK, [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] um
[CUSTOMER][NEUTRAL] OK, that'll come up like that, so I'll be aware that it's not spam.
[AGENT][NEUTRAL] Mhm. Correct. That's why I was letting you know what it was, the email would be from, [PII] and I will put [PII] in the subject line.
[CUSTOMER][NEUTRAL] Right. OK. Well, uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, cause a lot of stuff goes in.
[CUSTOMER][POSITIVE] OK, well thank you so much and you have a blessed day. I'll be waiting. OK, thank you.
[AGENT][NEUTRAL] Uh, yeah.
[AGENT][POSITIVE] Well, yes, ma'am. Well, I hope you have a blessing. Is there anything else I can help with?
[CUSTOMER][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] No, you just, no, I appreciate it though.
[CUSTOMER][POSITIVE] Thank you so much. Have a blessed day. Bye bye.
[AGENT][POSITIVE] OK. All right, Ms. [PII]. Well, it was my pleasure. I hope you do too. Thank you again.
[CUSTOMER][NEUTRAL] Bye bye.