AccountId: 011433970860
ContactId: 22632bc7-afb8-4050-a637-4dd17d63b189
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 388980 ms
Total Talk Time (AGENT): 187860 ms
Total Talk Time (CUSTOMER): 137031 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/22632bc7-afb8-4050-a637-4dd17d63b189_20250115T23:49_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling APL this is [PII] how may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and my husband, [PII] has um coverage through you folks.
[CUSTOMER][NEUTRAL] And I was wondering, and I don't know how this works, but I have dental insurance through my work, which is primary on me.
[CUSTOMER][NEUTRAL] Can
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, do you guys ever pay on the dental what my insurance doesn't pay?
[CUSTOMER][NEUTRAL] Does that make sense?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Um, Ms. [PII], I'll be able to look if you can give me your callback number and I'll check the dental benefits for you. I'll need your callback number just in case our call is disconnected.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then what is the policy number?
[CUSTOMER][NEUTRAL] It's 024.
[CUSTOMER][NEUTRAL] 79,050
[AGENT][POSITIVE] Thank you ma'am let me look the policy up.
[AGENT][NEUTRAL] OK, Ms. [PII], uh, can you verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Mm [PII].
[CUSTOMER][NEUTRAL] What was the other
[AGENT][NEUTRAL] The cell phone number that is on the policy?
[CUSTOMER][NEUTRAL] The phone
[CUSTOMER][NEUTRAL] OK. Um, I
[CUSTOMER][NEUTRAL] That's me
[CUSTOMER][NEUTRAL] I don't wanna go that way, you know, with cell phones, I don't know any numbers anymore.
[AGENT][NEUTRAL] I don't either.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEGATIVE] And don't even ask me to tell you what my number is because I just never see it.
[CUSTOMER][NEUTRAL] Exactly, I believe it's um [PII].
[AGENT][POSITIVE] OK thank you so much I appreciate you verifying the policy for me.
[AGENT][NEUTRAL] OK, let me see what kind of dental policy you guys have, um, OK, so his policy, your, your policy that you have with us is um.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Based on
[AGENT][NEUTRAL] Usual customary reasonable payment, which the dentist office.
[AGENT][NEUTRAL] Goes by that it.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] It's not one of those policies that if your primary insurance doesn't pay, we'll pick it up. What it is is the procedures that are billed from the dentist's office, then it pays that.
[AGENT][NEUTRAL] So it's not like
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] A gap plan that I that I know of, you know, where it picks up what the primary does it.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I wonder if
[CUSTOMER][NEUTRAL] These guys are the same.
[CUSTOMER][NEUTRAL] And I always have to go with mine first. I can't put you guys primary, can I?
[CUSTOMER][NEUTRAL] I don't think so. OK.
[AGENT][NEUTRAL] I mean, as far as the policy is concerned.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] You guys both just have coverage with us. We don't have anything on here about you having a primary insurance.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you show that we only have dental correct?
[AGENT][NEUTRAL] Let me check and see if there's any other policies you guys have together.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No, ma'am. Um, there is, let's see.
[AGENT][NEUTRAL] Well, dental is the only one that you're going to be on. Let me see if you're on this other one, the group term life.
[CUSTOMER][NEUTRAL] Oh, OK. He
[AGENT][NEUTRAL] It's an individual policy, so we have the group term life with him and the short term disability, short term disability is always only the insured that the work insured.
[CUSTOMER][NEUTRAL] Yeah, I
[CUSTOMER][NEUTRAL] On the, yeah.
[CUSTOMER][NEUTRAL] OK, I just couldn't remember if he did medical also.
[CUSTOMER][NEUTRAL] And the medical might be through somebody else.
[AGENT][NEUTRAL] It could be because I don't show that he has a medical policy with us.
[CUSTOMER][NEUTRAL] OK. I need to find that paperwork.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] I will find out what, what my insurance paid and go from there so let's say that they didn't.
[CUSTOMER][NEUTRAL] Pay everything of what is customary.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You still wouldn't, you still wouldn't pay secondary on that.
[AGENT][NEUTRAL] Well what you would do and this is just to verify your coverage, it's not a guarantee of payment, what you would do is you can send the dental claim in yourself if you'd want to um.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just send the, send it in yourself and then um the claims department will examine it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The remainder balance, not the.
[CUSTOMER][NEUTRAL] Remainder, OK, I'll talk to the dentist.
[AGENT][NEUTRAL] Right. You can show what, right. You could show what the, uh, cause you'll have to send in you, you know, the itemized statement with the procedure and diagnosis codes and all that. And they can look at it and examine it and see if there's anything that this insurance will pick up.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEGATIVE] That wasn't paid for.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright perfect I will get with the dental company and office and have them do what they can do to help me.
[AGENT][POSITIVE] Yes ma'am, and they're really good about helping most offices are there.
[CUSTOMER][NEGATIVE] Yeah, they want their money.
[AGENT][NEUTRAL] Yeah, that's true.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] OK, well, is there anything else I can help you with? You're so very welcome.
[CUSTOMER][POSITIVE] OK, perfect, thank you for your help.
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] OK, Ms. [PII], you have a great night and thanks for calling APL.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Hm. Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Mm bye-bye.