AccountId: 011433970860
ContactId: 1e8dc9bc-9249-4578-9e50-e92818a721ec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 808919 ms
Total Talk Time (AGENT): 374239 ms
Total Talk Time (CUSTOMER): 262014 ms
Interruptions: 4
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/1e8dc9bc-9249-4578-9e50-e92818a721ec_20250430T15:02_UTC.wav
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[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Your phone is breaking up?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] This is with APL. Can you hear me better now?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][POSITIVE] Yes, I can hear you better now.
[AGENT][POSITIVE] Sorry about that. My name is [PII] with American Public Life. How may I help you today?
[CUSTOMER][NEUTRAL] Um, yes, I was calling trying to see what benefits I have for the dental program that I'm, um, I'm under.
[AGENT][POSITIVE] Absolutely. Happy to check that for you. Do you have your policy number?
[CUSTOMER][NEUTRAL] Yes, it's 258-560-3.
[AGENT][POSITIVE] Thank you for that. Give me just one moment please while I pull that up.
[AGENT][NEUTRAL] And then for security, I will need to verify your first, last name, date of birth, please.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you and then lastly I need to verify your physical address and email address please.
[CUSTOMER][NEUTRAL] Physical address is [PII], and what else you needed need her?
[AGENT][NEUTRAL] The email address and physical address.
[CUSTOMER][NEUTRAL] Oh, [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you so much. OK, I'm just pulling up the plan here. Give me just a second, it's loading.
[CUSTOMER][NEUTRAL] OK, so is any way that you can email me a copy of my um.
[CUSTOMER][NEUTRAL] On my insurance card because I don't, I don't have it.
[AGENT][POSITIVE] Yeah, absolutely. I can send you a copy of that, not a problem.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm sorry, this is taking a moment. It's just loading and loading here.
[CUSTOMER][NEUTRAL] It's OK
[AGENT][NEUTRAL] OK. Thank you for your patience, Ms. [PII]. So, what kind of questions did you have as far as like what's covered on here? Did you wanna know percentages? What do you?
[CUSTOMER][NEUTRAL] The percentage everything because I wanna try to um make an appointment to the dentist and everything. I wanna know what and um what they cover.
[AGENT][NEUTRAL] OK. So your plan covers preventative, basic, and major. Uh, so what that means is that preventative is covered at 100%. So you can go to the dentist and have your routine cleaning done, and that would be covered at 100%.
[CUSTOMER][NEUTRAL] And everything.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Basic expenses are things like fillings, um, simple extractions, if you had to have like a simple tooth pulled, uh,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Things like that and those are covered at 80%, so we cover 80% of the cost.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then major expenses are covered at 40%. Major expenses are gonna be things like um multiple like extractions, oral surgery, um, let's say if you had to have, um,
[AGENT][NEUTRAL] Like, they call it periodonnal maintenance, where they have to do like a very deep cleaning, um, crowns, bridges, dentures, those things are considered major.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Your policy does not cover any sort of orthodontic treatment.
[AGENT][NEGATIVE] Um, it does not cover, uh, any sort of implants, like, uh, permanent implants. It would cover like
[CUSTOMER][NEUTRAL] Really?
[AGENT][NEUTRAL] Yeah, it covers like a denture but not an implant.
[CUSTOMER][NEUTRAL] So, um, can I upgrade to where it covers the implants or?
[CUSTOMER][NEGATIVE] The insurance company just doesn't cover the implants.
[AGENT][NEUTRAL] I'll be honest with you, I've never seen implants covered on any of our plans.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, and that's what I want. Do they cover veneers?
[AGENT][NEUTRAL] Uh, let's see if I see anything for veneers.
[AGENT][NEUTRAL] Probably gonna be under nature.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] I don't see anything on here.
[AGENT][NEUTRAL] For any sort of like uh
[AGENT][NEUTRAL] Veneers or anything. The only thing is just um
[AGENT][NEUTRAL] Looks like refers to.
[AGENT][NEUTRAL] Like denture repair, replacement as far as like any of that.
[AGENT][NEGATIVE] But nothing in there that I see about veneers that looks like unfortunately.
[CUSTOMER][NEUTRAL] So I, I have a question, right? So, um.
[CUSTOMER][NEUTRAL] With this dental insurance you said it doesn't cover the.
[CUSTOMER][NEUTRAL] The implant and um so if I get another type of insurance, will both of them cover what what the other one doesn't cover or would it be a conflict of it of the insurance?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] If you wanted to look into like, yeah, if you wanted to look into like a secondary, you could have this as like your primary and then have your secondary pick up any excuse me, anything that your primary doesn't as, you know, like implants, veneers, um, if you found something where that was covered, you could absolutely do that. Yeah.
[CUSTOMER][NEUTRAL] You get what I'm saying?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So how would I um
[CUSTOMER][NEUTRAL] So what I have to let you guys know that OK you're gonna be the primary insurance and then the other insurance would be secondary or.
[CUSTOMER][NEUTRAL] I'm saying, do I have to notify you guys on who's gonna be, you know.
[AGENT][NEUTRAL] No, you don't have to. Mm mm, no, you, they would just, you would just let the provider that you're seeing know that you have two dental insurances and let them know American Public Life is my primary, so please bill them first and then bill this insurance as my secondary. Um, yeah, it doesn't matter to us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, OK, OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright, so what percentage would it be for um for an office visit? What will my co-pay be? Or do I have a copay for an office visit?
[AGENT][POSITIVE] So, office visit it shouldn't cost you anything. If you just wanna go for like a consultation or a basic cleaning, everything should be covered at 100%.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] OK, so that's what I definitely wanted to know before I make up um appointment for a consultation on everything. OK, thank you. I really appreciate your help. You were very helpful.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Yeah, not a problem, and that card is on its way to your email, so you should have that here shortly and also just keep in mind that.
[AGENT][NEUTRAL] Any provider that you do go and see can contact us to verify your benefits. They can also put together a pre-determination plan for you and let you know if if you're if it's paying 40% here, then they should let you know what that 60% is that you're gonna have to pay before you even agree to any sort of services so.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so, alright, just like you say the you guys for the major is 40%. So if I y'all pay the 40 and then the other secondary can cover the rest.
[AGENT][NEUTRAL] Well, that would be, yeah, it could, you know, it would depend on what that plan is that you pick up for a secondary as far as what that coverage looks like. Um, I'm just, you know, just saying that the dentist should be able to let you know if you didn't have a secondary, what the cost for yourself would be like out of pocket. They should be able to let you know that before they even, you have any services rendered.
[CUSTOMER][NEUTRAL] Or no.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, OK, OK, that's good because that's what I was worried about. I don't wanna get in the chair. They were like, OK, you owe us $2000 like whatever you just did, put it back.
[AGENT][NEGATIVE] Right, right, that's, yeah, that's my, yeah, that's what I was trying to get at is like that way you don't have any surprises and you have all this work done, and they're like, oh hey, by the way, that's $5000 and you're like, what? Excuse me? Like, yeah, they should be able to tell you, hey, you need X, Y and Z done and this is what it's gonna cost you if you wanna have X, Y, and Z done. So yeah, no surprises, hopefully.
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] OK, yeah, that's what I'm saying cause I'm like, OK, whatever you did, put it back or call [PII] cause I'm going to jail. I don't have 5000 for you. I don't have to file for you. So they gonna let me come, come get me some. You should have told me this before you went to pull it and snatch it. So I need to know before you do anything on how much this gonna cost me, sir.
[AGENT][NEUTRAL] Right, right. I, I changed my mind.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Yeah, exactly. No, I hear you cause ain't nobody got time for that in this economy right now, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Exactly. So I'm on a budget. I'm trying to figure out every that's why I'm like, OK, I can fucking afford a secondary, the, the cover there, whatever, yeah, everybody gonna cover then I'm like, OK, I, I can afford 10% on one of them, but oh, everything's so expensive now.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] It is, it is, it is.
[CUSTOMER][NEGATIVE] It make you don't wanna go to no doctors, no it'll make you don't want it because it's so expensive and then I'll be seeing why people be going to other countries, but right now.
[CUSTOMER][NEGATIVE] I don't know about going to another country. I don't think it's safe.
[AGENT][NEUTRAL] I mean, I hear you on that too. I hear a lot of people that do do stuff like that, but I have never been brave enough to venture and do that myself, so.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEGATIVE] Exactly, I'm, I'm terrified like, listen, I, I look at too much TV.
[AGENT][NEGATIVE] Man, I'm scared to go to the doctor in the [PII], much less anywhere else, OK? Like, no.
[CUSTOMER][POSITIVE] Thank you. And then I wake up and like, oh, what? And I wake up I'm in a dungeon somewhere, so I'm like.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Mm hmm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEGATIVE] No, I ain't trying to be in that movie. No, no, no.
[CUSTOMER][POSITIVE] I'll tell you exactly, exactly, exactly. So I'm like, no, I'll take my chances. I, I'll figure it out. So, alright.
[AGENT][NEUTRAL] I hear you, I hear you.
[CUSTOMER][NEUTRAL] So thank you for your help. So let me try to find a um a dentist in my area that takes this insurance.
[AGENT][POSITIVE] OK. Yes, ma'am. And if you need any other um questions, if you have any other questions or need help, just give us a call. We're happy to help.
[CUSTOMER][POSITIVE] Alright thank you have a good one.
[AGENT][POSITIVE] You too have a blessed day.
[CUSTOMER][NEUTRAL] OK bye bye.
[AGENT][NEUTRAL] Bye bye.