AccountId: 011433970860
ContactId: 2d58e207-d73f-4633-8e56-46e9598bd868
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 405980 ms
Total Talk Time (AGENT): 240379 ms
Total Talk Time (CUSTOMER): 118092 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/2d58e207-d73f-4633-8e56-46e9598bd868_20250513T17:50_UTC.wav
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[AGENT][NEUTRAL] Good afternoon thank you for calling APL. This is [PII] in the customer service department. How may I help you?
[CUSTOMER][NEUTRAL] Yes, I'm calling. Um, my husband and children have, um, dental insurance through you all, and I'm trying to see how it works because I had made a dentist appointment and they want me to pay like 300 bucks up front and then file a claim. Is that how that works? I pay them and then you all pay me back.
[AGENT][NEUTRAL] It actually depends on what type of coverage you have. So in order for me to be able to help you further, is it possible to get your name and a callback number, and then I'll need to get the policy number too, please.
[CUSTOMER][NEUTRAL] Um, well, as for the, the policy is on the Sorrento [PII], my husband.
[AGENT][NEUTRAL] OK. And what's your name?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you for that, Ms. and I just need a callback number in the event that we get disconnected, that's all.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 210.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And do you happen to have his policy number?
[CUSTOMER][NEUTRAL] Yes, it's uh 254.
[CUSTOMER][NEUTRAL] 386 9
[AGENT][NEUTRAL] OK, give me just a second.
[AGENT][NEUTRAL] And can you verify your date of birth and the mailing address for you guys, Ms. [PII]?
[CUSTOMER][NEUTRAL] My date of birth or his date of birth?
[AGENT][NEUTRAL] His date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so you're calling on his behalf, Ms. [PII]?
[CUSTOMER][NEUTRAL] Well, I'm calling on my son's behalf, but I, I mean, I can get him on the phone if I need to, but I'm just trying to find out.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] How it works. That's fine. I just, I just needed to know who I'm speaking to and what did you to help us with that. Yes, ma'am. And so, can you verify your son's date of birth and his first name?
[CUSTOMER][NEUTRAL] Yeah, I'm the wife. uh-huh, yeah.
[CUSTOMER][NEUTRAL] So [PII], they got it spelled wrong on the policy because I'm looking at it online, but it's [PII] [PII].
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. What's the correct spelling of his first name?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, bear with me, let me fix that real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give me just a second.
[AGENT][NEUTRAL] I'm sorry, can you give me that number again? It wouldn't let me change it without going out and coming back in. You said it was 25.
[CUSTOMER][NEUTRAL] Which the policy number 254.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 2543869
[AGENT][POSITIVE] Thank you for that, bear with me.
[CUSTOMER][NEUTRAL] It.
[AGENT][NEUTRAL] And what did you say you guys' mailing address was?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you for that Mr. [PII], and are you able to verify the email account that's on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. So, um, I can verify what you're asking, but just so you know, for future, you might want to get Mr. [PII] to contact us. um, he can either call us to say it's OK to talk to you, but if he calls us that only allows us to speak to you for that day, just 24 hours only, but he can send something in writing and that lasts for a year and that's only due to HIPAA. We have to make sure who we're releasing information and that he's aware of it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, he can fax or email that, but to answer your question, you can see any dental physician, you're not locked in on a specific provider network, you guys are at free standing to see anybody. Most of the time, the providers contact us, verify your benefits, and we let them know how much they're, you know, we're gonna pay within the policy and then that whatever we don't pay, of course, is your responsibility, your out of pocket expense, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] If they're not wanting to file with us because it sounds like that's what they're telling you, they're not wanting to file with us then.
[CUSTOMER][NEUTRAL] Yeah, see, the business I'm using is right here in my local area and they were saying they never heard of this insurance before, so I have to pay everything out of pocket, then they would file it, and if you all pay, they just put a credit to my account for the next time I come back and all he's going for is a screening because he's a new patient, so he's been like a cleaning and X-ray, but they want me to pay like 30-400 bucks out of pocket. That's why I was trying to see. I may just have to go with another dentist.
[AGENT][NEUTRAL] Yeah, it's just, right, it sounds like they're not wanting to file with us and all they have to do is just call us and we will let them know, hey, we are dental insurance. We are the dental company, here's how you can file, here's what the benefits are. Um, but some people because they've used the physician and they've been using it for a while and the physician doesn't want to file with us, they just, they pay out of pocket and then they file the claim directly with us. So you do have that option.
[CUSTOMER][NEUTRAL] That's what I was thinking.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] But of course, you know, like you said that.
[CUSTOMER][NEUTRAL] Well this will be a new one so I'll just go to somebody else.
[AGENT][POSITIVE] Yeah, it just, it just let them know it is dental insurance. You're not locked in a specific network. You're a free standing to see if they will just pick up the phone and call us, we will be more than glad to verify benefits and how they can file directly with us, so that keeps you out of the loop.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, you can try that and see if that works, Ms. [PII]. Um, but again, just, just get Mr. [PII] to send us something in writing. He can fax it or email it. Would you like her email address just in case, um, since you, it's gonna be care, [PII]
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Yes, what's the email address?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] At
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII] and that's all one word, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You said [PII] or [PII] or AM. What did you say? What's the last [PII].
[AGENT][NEUTRAL] A M, A as in apple, M as in mom.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Yes ma'am, [PII] and once we get that, like I said, it's good for you.
[CUSTOMER][NEUTRAL] And what does it need to say that you all have permission? Mhm.
[AGENT][NEUTRAL] To speak to you and we need your full name, in which I'm gonna notate that I spoke to you but just to kinda for you to be able to get more details in the future that's what that's gonna help with so.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, Ms. [PII]. Is there anything else I can help you with before you go?
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] No, that'll be all. That'll be all.
[AGENT][POSITIVE] Well, thank you for calling APL Miss [PII]. You have a wonderful day as well.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Thank you