AccountId: 011433970860
ContactId: 2095c1c4-a7b2-47b8-953e-3595ac71b574
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 598330 ms
Total Talk Time (AGENT): 325140 ms
Total Talk Time (CUSTOMER): 111615 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/2095c1c4-a7b2-47b8-953e-3595ac71b574_20250424T22:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, hey, hey, I, I got a, um, I'm, I'm a member of y'all a plan. I just got the card in the, um, mail today. I'm just trying to see, do I still got dental insurance and medical insurance.
[AGENT][NEUTRAL] Do you have a policy number I can pull up?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] They say like to my employee ID?
[AGENT][NEUTRAL] Um, it should say certificate number.
[CUSTOMER][NEGATIVE] Certificate number mm you ain't on the card I got.
[CUSTOMER][NEUTRAL] He had got a card in the mail.
[AGENT][NEUTRAL] You don't see anything on the card that says member ID or certificate number?
[CUSTOMER][NEUTRAL] Member ID?
[AGENT][NEUTRAL] What is that?
[CUSTOMER][NEUTRAL] It's a group number, like it, it, it's like 4, it's like a four digit number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You can give me the group number. What's the group number?
[CUSTOMER][NEUTRAL] 9491.
[AGENT][NEUTRAL] What is your last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] First name?
[CUSTOMER][NEUTRAL] The [PII].
[AGENT][NEUTRAL] Is your first name spelled [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Let me just do a search.
[AGENT][NEUTRAL] Date of birth, please?
[CUSTOMER][NEUTRAL] A the [PII].
[AGENT][NEUTRAL] Thank you. And then I just need to verify lastly your physical address, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Right, so I do show that you have active dental and medical coverage with us as of [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Correct. Uh-huh.
[CUSTOMER][NEUTRAL] You said April. It just, it just started [PII]?
[AGENT][NEUTRAL] That's what it shows as an effective date [PII], yes.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] So, can I add somebody on my dental?
[AGENT][NEUTRAL] What kind of questions did you have on the dental?
[CUSTOMER][NEUTRAL] Like a tea
[AGENT][NEUTRAL] You're wanting to know if it covers, OK, you're wanting to know if it covers like extractions?
[CUSTOMER][NEUTRAL] To get a T4
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the dental plan that you have with us only has uh preventative and basic coverage. So under basic, um, it does cover extractions, um.
[AGENT][NEUTRAL] My recommendation would be, it covers 80% of the cost. That's what your plan covers is 80% of whatever the cost is for an extraction.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] My recommendation would be to find a dentist that you wanna go to, um, they can contact us and verify your benefits and everything. Um, once you have a consultation with them, which is also covered underneath your plan, um, they should be able to give you exactly what the cost would be, um, to have any extraction done.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, cause I, cause I'm trying to get, I got like a little teeth tooth in my mouth. I'm trying to get out too, a little raw teeth out my mouth.
[CUSTOMER][NEUTRAL] I wonder how much, what I got, I gotta find a dentist to, to do that.
[AGENT][NEUTRAL] That would be my recommendation if you're wanting to know like what your out of pocket cost is gonna be. Only a dentist can provide you with what the cost is gonna be um based off of what they charge for that. Your plan doesn't have any sort of major coverage, so it's not gonna cover any sort of oral surgery. It's not gonna cover any sort of like implants.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, dentures or anything like that. Um, it's pretty just basic as far as cleanings, a simple extraction, or if you have to have like a filling.
[CUSTOMER][NEUTRAL] Oh, OK, OK, so you, I got another question. So what my medical use, how my medical is it basic too?
[AGENT][NEUTRAL] Your medical is what we call a limited benefit plan. So this plan pays a set amount just depending upon what you're being seen for. It's not considered major medical. So, for example, if you're going to a doctor's office for let's just say,
[AGENT][NEUTRAL] Um, an office visit, you can go to the doctor for an office visit. Um, it's going to pay just a set amount towards the visit and nothing additional. So it's not going to be like major medical where you have a co-pay of $25 for the office visit.
[AGENT][NEUTRAL] Your plan itself, it looks like pays towards an office visit $50 and it allows you 4 office visits in a calendar year.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Um, it does also have coverage on your plan for urgent care, emergency room, uh, things like that if that was needed. Your plan does also have a prescription drug benefit on it as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] So when I go somewhere, I get sick or something and give me some med, I, I gonna pay for my mess.
[AGENT][NEGATIVE] It'll pay $10 a day towards the drugs. It's not probably gonna cover the entire cost. Uh, it's gonna pay just that $10 per day. Same with if you went to urgent care and you were sick, it'll pay $50 towards the urgent care visit. Um, it's not gonna pay anything additional. That's another situation though, DeMarcus, where we don't know what that urgent care cost, that fee is to go see them.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] So if it's $200 we're gonna pay the $50 and then the responsibility would be $150 for you.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] So, y'all dealing with the um life insurance too.
[AGENT][NEUTRAL] Um, let me see if you have life with us. I'm not sure, one moment.
[CUSTOMER][NEUTRAL] Like [PII], she told me a notice. It was like another way.
[AGENT][NEUTRAL] So, I don't show any life insurance with us. You have medical, dental, and you have an accident policy.
[CUSTOMER][NEUTRAL] Yeah what's the accident policy that was like what the.
[AGENT][NEUTRAL] Or you want to know
[CUSTOMER][NEUTRAL] The answer probably what it was.
[AGENT][NEUTRAL] What it covers, is that what you're
[CUSTOMER][NEUTRAL] What are they, yeah, yes.
[AGENT][NEUTRAL] So accident plan is going to pay um for hospital, um, physician's office, emergency dental. Um, these are all, of course, going to be like, if you needed to be in a hospital because of an accident, um, if you were admitted to the hospital because of an accident.
[AGENT][NEUTRAL] Um, it has an ambulance benefit, medical imaging.
[AGENT][NEUTRAL] It does have an accidental death and dismemberment on it. Um, there's a benefit amount for death and dismemberment.
[CUSTOMER][NEUTRAL] How much
[AGENT][NEUTRAL] Accidental death is uh for the insured is 15,000. Dismemberment is also, it looks like 15,000. That would be for both arms and legs. Both arms, legs, hands, or feet or eyes is 7500. 1 arm, leg, hand, foot, or eye is 3750. A finger or a toe is 1000.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh, OK. That's all I wanna know.
[AGENT][NEUTRAL] All right. Anything else I can do for you?
[CUSTOMER][NEUTRAL] Cause I had yet to got the card and then.
[CUSTOMER][NEUTRAL] Yes sir.
[AGENT][POSITIVE] All right. Well, thank you for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] All right, bye-bye.