AccountId: 011433970860
ContactId: 1c2752da-7e74-4093-a763-e038fa18a8b0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 441079 ms
Total Talk Time (AGENT): 214517 ms
Total Talk Time (CUSTOMER): 129933 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/1c2752da-7e74-4093-a763-e038fa18a8b0_20250527T14:37_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 [PII], my name is [PII], and I've got insurance through y'all, and a dentist just tried to call and some lady told him that my insurance was inactive since November.
[CUSTOMER][NEUTRAL] And I just started this company in November and got the insurance after that, so it's kind of hard for it to be inactive if.
[CUSTOMER][NEUTRAL] I'm currently paying for it.
[AGENT][NEUTRAL] OK, I'll take a look into the policy for you. Um, I do apologize for the confusion. May I have a good contact number in case we're disconnected and your policy number?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] And I got the payer ID number, the policy certification number, and a group number. Which one do you want?
[AGENT][NEUTRAL] The policy number is your policy number?
[CUSTOMER][NEUTRAL] OK, OK, 025.
[CUSTOMER][NEUTRAL] 895887
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] The mailing address? I, I don't remember cause my license says one thing, but I'm going by another because I don't live currently live there anymore. Is it [PII] or [PII]?
[CUSTOMER][NEUTRAL] Or [PII].
[AGENT][NEUTRAL] Oh wow, my family is from [PII]. Um, it's [PII].
[CUSTOMER][NEUTRAL] One of the 3.
[CUSTOMER][NEUTRAL] Are they?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] Alright, and then just your email.
[CUSTOMER][NEUTRAL] And what was the last
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. Um, let me see, hold on one moment.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Um, so your policy is active. The policy has been active since [PII], um, and the notes are showing that [PII] just called and we went over everything with her and faxed over the benefits. So I'm not sure where the disconnect is, but um,
[AGENT][NEUTRAL] We let them know that it was.
[CUSTOMER][NEGATIVE] Yeah, she just called me and said that said that the agent she talked to said that it was inactive since November and they was gonna try to call again and talk to somebody else and I'm like, oh you know I've been paying on it weekly.
[CUSTOMER][NEUTRAL] So I know it's active.
[AGENT][NEUTRAL] Yeah, I don't know if they
[AGENT][NEUTRAL] If they, um, what policy number she has, I don't know, but the, it's active, it's been active since [PII] and I can, if you want, let me see if she put the fax number in the note.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] I can fax them over another copy of your benefits.
[CUSTOMER][NEUTRAL] If you don't mind, that would be great because I need to get this tooth pulled and I don't need any more issues.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Oh, now, hold on now. Let me take a look at the
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Benefit
[CUSTOMER][NEGATIVE] Oh, that's not, that's not a good sign.
[AGENT][NEUTRAL] Because just because the policy is active, let me look and see what, what, if they're talking about a waiting period or something like that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so hold on, let me pull up.
[CUSTOMER][NEUTRAL] Waiting period.
[AGENT][NEUTRAL] Mhm. So like if you're, you, you mentioned your tooth being pulled, so some, depending on if it.
[AGENT][NEUTRAL] If it's just a simple extraction, that's considered basic, but if it's something like where they have to like, I don't know.
[AGENT][NEUTRAL] Crack it and all that stuff and pull the tooth, then that's considered major. For that, your policy can be active, but there could be a 12-month waiting period for your major services. You have to have the policy at least a year before we'll pay out for the, the policy will pay out for the major expenses, but I'm gonna see if that's what's happening because that's the only other thing I can think of for the policy being active, but you have to wait for something.
[CUSTOMER][NEUTRAL] Well, see, that's the thing about it is, is without actually going to because I don't have an appointment till [PII] without them looking at the tooth to see what needs to be done, how would they know what to put in?
[AGENT][NEUTRAL] Right, so if there will
[CUSTOMER][NEUTRAL] You see what I'm saying? They don't know, they don't.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] So at this point, they're just calling to see what the coverage is, just, you may not need the major, but they're calling to see in case you do. So it might not be needed, but it could just be basic, but they're calling to see what all you have, but I don't know that that's the case. I'm waiting for the benefits to come up now so I can see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] CBA OK, here we go.
[AGENT][NEUTRAL] Yeah, that's what it is. So your policy is active and it's been active since March, but the policy has
[AGENT][NEUTRAL] It covers preventative, basic, and major. For your major expenses, there is a 12-month waiting period, so that may be what they're referring to. Since the policy became effective on [PII], if major is needed.
[AGENT][NEUTRAL] You wouldn't be able to use the insurance until [PII] for the major part of it. But they're just calling, like you said, they're just calling to get the coverage. They don't know what all is needed, but if it is, that is what what they're referring to.
[CUSTOMER][NEGATIVE] Oh, OK, and that might cause an issue because if it is and if, if, I mean, I think it's just simple ins uh extraction, but if it is anything major, I'm gonna be kind of screwed because I'm broke and I ain't no way I can pay for that.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] [PII]. Alright, well, let me, let me call them back and find out what's going on and see what they're thinking and everything and I'll work from there I guess.
[AGENT][NEUTRAL] Alrighty, well, just let us know and um you said you do want me to go ahead and send over another copy?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][POSITIVE] OK, I can send it because she put the um fax number here, so I'll go ahead and send that for you now.
[CUSTOMER][POSITIVE] Alright, I appreciate it.
[AGENT][POSITIVE] You're welcome, Mr. [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] Alright, well, thanks for calling [PII]. I hope you have a good day.
[CUSTOMER][NEUTRAL] All right, you too.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] Alright bye bye.