AccountId: 011433970860
ContactId: 3bd8a695-adbb-4410-8253-38cc2c180bcc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 806820 ms
Total Talk Time (AGENT): 428499 ms
Total Talk Time (CUSTOMER): 160594 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/3bd8a695-adbb-4410-8253-38cc2c180bcc_20250115T20:54_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I was calling because I received some cards in mail for the insurance, and I'm trying to see what does it cover or do I need to make a log in? I'm not sure.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well, I can help you with the cards and um the login as well. And Ms. [PII], may I have a good contact number in case we're disconnected and your policy number?
[CUSTOMER][NEUTRAL] OK, my phone number is [PII].
[CUSTOMER][NEUTRAL] And the policy number is 02580848.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] OK, and I have you here and I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] And date of birth is [PII]. Date of birth.
[CUSTOMER][NEUTRAL] Um, mailing address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] My email is [PII].
[AGENT][NEUTRAL] Alrighty, and thank you so much for verifying and all the information provided is a verification of benefits, not a guarantee of payment. So, um, for your hospital indemnity policy, you have, well, it's a few different benefits. So you have like if you're ever admitted to the hospital, there's an admission uh benefit that the policy will pay up to $1000 for that first um admission and then
[AGENT][NEUTRAL] For up to 30 days after um the 1st 18 hours, the policy will pay up to $100 a day if you're ever confined to the hospital. You also have intensive care benefits, um, and like a rehabilitation center benefit.
[AGENT][NEUTRAL] Um, if there's ever any surgery needed for accident or sickness, um, whether it's in a facility or a physician's office.
[AGENT][NEUTRAL] Um, for the facility, you would pay up to $1000. So like the hospital or uh
[AGENT][NEUTRAL] Or a hospital building and then like a physician procedure in office, it will pay up to $250.02 times per calendar year. You have emergency room benefits, urgent care.
[CUSTOMER][NEUTRAL] You have
[AGENT][NEUTRAL] Um, physician office, physical therapy.
[AGENT][NEUTRAL] Um, diagnostic testing benefit.
[AGENT][NEUTRAL] There is an outpatient prescription drug benefit. Um, and then like if there's the ambulance ever needed, um,
[AGENT][NEUTRAL] And then there's a preventative elective surgery, if any in-office procedures are needed, um.
[AGENT][NEUTRAL] Those benefits will pay for that as well and then you have critical illness rider with um
[AGENT][NEUTRAL] Cancer.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then you also have a, let me see, yeah, you also have a dental policy with us too.
[CUSTOMER][NEUTRAL] um, that's what I need the most, the dental policy, what comes with that?
[AGENT][NEUTRAL] Uh, let me go to, hold on one second, let me get that number.
[AGENT][NEUTRAL] 25848.
[AGENT][NEUTRAL] Hold on one moment, I'm pulling your dental policy now.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, so for the dental policy you have.
[AGENT][NEUTRAL] Oh, and just let me say for the call, I'm sorry, I don't know if I said it or not, but all the information provided is a verification of benefits, not a guarantee of payment. Um, for the dental, for the dental policy, um, there is a calendar year max of $500. Um, this is an individual policy, so yeah, $500 per person. There is a $50 deductible.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] The policy covers preventative, um, your images, basic expenses and basic restorative. So for example, um, like it, it covers your cleanings, your uh images, your evaluations, um, fluoride, sealants, if any spacers are needed, um, fillings.
[AGENT][MIXED] There is a simple extraction, but not like the oral surgery needed extraction.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And then the rest, these are all filling. So it covers um preventative and basic services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and um.
[CUSTOMER][NEGATIVE] Cause like my job had sent me this and I filled it out and then like a month later this when I got this in the mail and I don't, I, I wasn't aware if I was approved for it or not.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, yes.
[CUSTOMER][NEUTRAL] Cause they said
[CUSTOMER][NEUTRAL] You had to be approved or something like that.
[AGENT][NEUTRAL] Well, um,
[AGENT][NEUTRAL] I don't know about approved, but your policy has been at this time, let me see if it's both of them, most of the time it's the same date, but I just want to make sure.
[AGENT][NEUTRAL] Yeah, they both have been effective since [PII] of last year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what's the payment on it every month?
[AGENT][NEUTRAL] Let me see. For your medical policy, it's $23.75.
[AGENT][NEUTRAL] For your dental policy is $3.30.
[CUSTOMER][NEUTRAL] OK, so less than $30 a month and it comes right out my check, right?
[AGENT][NEUTRAL] Correct, but let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It it's, yeah, it's on payroll deduction. I just want to make sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, we're just making sure.
[CUSTOMER][NEUTRAL] Now how do I find out who, who accepts this kind of insurance? Do you have like a website where I can go on or do I have a, you know, can I get a list?
[AGENT][NEUTRAL] So, two things, um, for your for your hospital indemnity policy, let me see if I can switch back. Well, I'll do dental since I'm on it now. For your dental policy, um, it is through the Carrington PPO network on the back of your ID card.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, your dental ID card, it'll show uh Carrington's phone number and to get the list of providers. You can either call or you can go to our website, um, which is [PII].
[AGENT][NEUTRAL] And then you'll scroll all the way down to the bottom of that first page and you'll see um dental provider search and then it'll ask you for like your zip code and if you need a regular dentist or a specialist and then um like how far out, how many miles out you want it to search, and it'll come up with the list and the list whether you call or um do it online is the same.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] You said it's [PII]?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] But I had to make a log in, right?
[AGENT][NEUTRAL] Oh, so when you go to the website [PII]?
[AGENT][NEUTRAL] That same first page that pops up, if you look to the right, you'll see where it says sign in. Um it it may say sign up. You see it. If you click on that, that takes you to the online portal.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, cause it's telling me, asking me am I a new user and stuff like that.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Yes, and then you'll go to new user and put that you're an individual.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then it's gonna ask you for um like your last name, it's gonna say social security number or member ID put your full social in that field.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then
[CUSTOMER][POSITIVE] I'm doing it right.
[AGENT][NEUTRAL] Let me see which email.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And then once you get to the um create your username and password um it work correctly for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, it's going smoothly.
[AGENT][NEUTRAL] OK, good. And then for your
[AGENT][NEUTRAL] Well, that's the same if you need to um file claims to access your documents, it's gonna be the same portal for both of your policies.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But there's no um list of providers. Let me see if you have, hold on one moment, let me go back to the medical.
[AGENT][NEUTRAL] Um, so you don't have like a list of providers for your medical policy. Now, you do have the PPO network through multiplan. Um, so if you wanted to go to um [PII] to search for providers that take multi-plan PPO, you can.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, but your hustle indemnity benefits are the same no matter where you go. There's no network for that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you got me here.
[CUSTOMER][NEUTRAL] OK, so I mean.
[CUSTOMER][NEUTRAL] Yeah, that I've been affected since the [PII] of last month.
[CUSTOMER][NEUTRAL] Now, I'm just trying to find um.
[CUSTOMER][NEUTRAL] Dental doctors.
[CUSTOMER][NEUTRAL] And give me an option, see.
[AGENT][NEUTRAL] The what you're looking for?
[CUSTOMER][NEUTRAL] To um find a provider.
[AGENT][NEUTRAL] For dental
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Oh, did you go, you still in the, are you still in the online service center or you're back at the website?
[CUSTOMER][NEUTRAL] OK, I'm, I'm, I just finished logging in, it's in my.
[CUSTOMER][NEUTRAL] I just made the log in.
[AGENT][NEUTRAL] OK, um, if you
[CUSTOMER][POSITIVE] And it's showing me my coverage and stuff.
[AGENT][NEUTRAL] If you want to open up a new tab, you'll just have to um go back to our website.
[CUSTOMER][NEUTRAL] OK, go back to the website.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I'm at the website now.
[AGENT][NEUTRAL] Alright, so scroll all the way down to the bottom, like almost to where like careers and everything is, and you'll see uh.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Dental provider search. Hold on, I'm going to it also.
[AGENT][NEUTRAL] Yes, it it's Carrington Dental providers, you see it?
[CUSTOMER][NEUTRAL] OK, yeah, Carrington dentals. OK, yeah, uh-huh.
[AGENT][NEUTRAL] So you just click there and then.
[AGENT][NEUTRAL] The next page you'll click on search dental providers and it'll ask that's where it asks you for like your zip code and what type of dentist you're looking for.
[CUSTOMER][POSITIVE] Got you, got you, got you.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Alright, was there anything else I could assist you with today, Ms. [PII]?
[CUSTOMER][POSITIVE] That'll be all. Thank you so much.
[AGENT][POSITIVE] You're very welcome. Well, thanks for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] You too, thank you.
[AGENT][POSITIVE] You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEGATIVE] He was here today, um, it's unfortunate, but it's unfortunately not unique, um, this particular.