AccountId: 011433970860
ContactId: 484e73da-8e91-4da0-b0ad-9ecfc3b10f81
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 733929 ms
Total Talk Time (AGENT): 302011 ms
Total Talk Time (CUSTOMER): 292226 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/484e73da-8e91-4da0-b0ad-9ecfc3b10f81_20250505T13:20_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you very much for calling APO. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] What is your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK, so I'm calling on behalf of my husband [PII], um, and I'm calling because I need to know what all the dental insurance is paying for this year. I don't have his, um, medical, the card off hand.
[CUSTOMER][NEUTRAL] So because I can't give you the um the the number, the policy number at the time because I don't have it on hand.
[AGENT][NEUTRAL] OK, um, may I have your name?
[CUSTOMER][NEUTRAL] [PII], I'm his wife.
[AGENT][NEUTRAL] OK. And may I have a callback number just in case?
[CUSTOMER][NEUTRAL] And can I get on the phone, man.
[CUSTOMER][NEUTRAL] I was saying that [PII] is on the phone.
[AGENT][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Hello? Just, just tell her I'm driving an 18 wheeler, that's why you're talking for me. Hold on, yeah, my husband is on the phone he's driving, so, um, and we, yes, he is on the phone.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I need the policy number so I can verify him and get his permission before I let him go, OK?
[CUSTOMER][NEUTRAL] Well, like I said, we don't have the policy number offhand. He's driving. I'm at work. We don't have the policy number. Could you pull up by his date of birth?
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] By the name. Let me try the name, OK?
[CUSTOMER][NEUTRAL] And [PII] is [PII]
[AGENT][NEUTRAL] OK. Could you repeat that again?
[AGENT][NEUTRAL] The last name.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and the spelling of the first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, do you mind providing me the social?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Do you mind providing me the social?
[CUSTOMER][NEUTRAL] Very your social [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] I'm sorry, that was [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I do have you pulled up and you're giving me permission to release information to this job, correct?
[CUSTOMER][NEUTRAL] Yes, ma'am. If there's any way you all can know if there's any way you all can notate that um when I call her that, you, you all have permission to talk to me?
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] OK, you are listed on the policy, um, so all you need to do as long as you need information about you or your dependent, we can go ahead and release information now if you need information about or make changes or anything like that, you're gonna need an authorization form that I can send to the email on file.
[CUSTOMER][NEUTRAL] We're not trying to do no, no kind of um
[CUSTOMER][NEUTRAL] Changes or anything like that. What I'm trying to find out today is, mis so is what all the um dental portion is covering this year.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You need the benefit of the policy. I'm sorry, I'm having trouble hearing you said a portion of the policy. Is it benefit information or is it people that is in the policy that's gonna be pro um cover on the policy?
[CUSTOMER][NEUTRAL] No, it's the benefits we're trying to, it's the benefits we're trying to find out what all the, the insurance is covering this year.
[AGENT][POSITIVE] Be OK, benefits.
[AGENT][NEUTRAL] OK, so you need the benefits and what's covered.
[CUSTOMER][NEUTRAL] Cause you know, it changes every year with, with, yes, cause you know every year it changes so we're trying to figure out, find out now what is it covering this year.
[AGENT][NEUTRAL] Yeah, OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and for that information we can give it to you, um, because you again as long as you're listed on the policy, you're able to get information. The only thing that you need atization if if you're gonna make changes or anything like that, OK? Or you're not listed on the policy. All right, so yes, I can go ahead and give you the benefits and you need this information given to you verbally or you need me to send a breakdown of benefits by fax or I'm sorry, by mail or by email?
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] You can give it verbally or you and you can email it to me so I can have it in my file.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And may I have your date of birth for verification?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, can you also verify the mailing address for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage, and that's just a disclaimer. So with this policy, as long as um you don't make any changes, it's always gonna be the same, um, which usually is the same every year. Uh, you have a calendar year maximum of $1500 with the $50 deductible.
[CUSTOMER][NEUTRAL] I
[AGENT][NEGATIVE] And deductible does not apply to preventative.
[AGENT][NEUTRAL] This is your dental. Are you trying to get benefits for medical instead of dental?
[CUSTOMER][NEUTRAL] I need boat. No, that's, that's probably what it is right there. It's a medical. It's what I need both.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] But what I'm saying is the deductible is.
[CUSTOMER][NEGATIVE] That so basically that's the reason why I'm paying that amount at $1200.
[CUSTOMER][NEUTRAL] Uh because the the the deductible is how much say was 1100.
[AGENT][NEUTRAL] Deductible is, is uh $50. This is for dental, $50 each.
[CUSTOMER][NEUTRAL] $50 for dental is a deductible.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, all right, this, this is going on right now. Um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] We had this problem last year and they had a hard time trying to figure it out but I did have to come out of my pocket and pay. Now they're telling me again this year they say my insurance would not cover.
[CUSTOMER][NEUTRAL] My, I have to have a, a, a, a deep teeth cleaning.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] And they would say my insurance only covers one side. They only I can only get one side one day, then I have to wait to the next day to get the other side up, and it's $600 a side.
[CUSTOMER][POSITIVE] So that's really why we called in to find out about this part right here.
[AGENT][NEUTRAL] OK. Uh, so the deep cleaning, um, is pay at 40%. Um, and then, um, we don't have that type of limitation. I don't know if the place that you're going into has that limitation, but we don't have a limit if you're gonna do it both side or one side at a time.
[AGENT][NEUTRAL] Um, again, it only covers 40% and you only have 1500 maximum per year.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] They only covers 1000, but like I said, the teeth cleaning altogether is 1200.
[AGENT][NEUTRAL] Correct, um, the amount that they charge, you know, it depends on where did you go, they charge based on the place or the area that you're trying to do any type of cleaning or any type of procedures. Um, now, again, we only cover 40% or a deep cleaning because that is a major service. So, um, no matter where you go, it's you're gonna pay a 40%. So we're paying the 40%, you're paying the rest of it.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so yes, you're gonna have an out of pocket amount. Mhm. But again, um, based on if you need to wait to do the left or the right, we don't have that limitation, so it is not something that we required. You can do both at the same time because we don't have that limitation on the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Oh, I'm
[CUSTOMER][NEUTRAL] I'm glad you told me that. I'm glad you told me that, so I can't get it all done in one day.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Alright, thank you very much for that information, but uh.
[CUSTOMER][NEUTRAL] Let me, let me let my wife talk to you. Hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] See.
[CUSTOMER][POSITIVE] Great.
[CUSTOMER][NEUTRAL] I'm here, um, the thing with it is they only pay 40% and the 60% gotta come out of your, out of our pockets.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Hey, we discussed that already finished talking about. OK, the medical part of it because he has to have um extractions, two extractions of the wisdom tooth in his mouth. That's the medical part of it, correct?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, mm. No, that will be dental. Anything that has to do with the uh mouth and, and teeth, yeah, it's dental.
[CUSTOMER][NEUTRAL] It's still dental?
[AGENT][NEUTRAL] Yeah, that is dental, um.
[AGENT][NEUTRAL] And, and that's gonna be also, it depends on uh you said it was the wisdom teeth, the wisdom teeth is gonna be a surgery because they, they cannot pull those without having a surgery. So um that means that that one is.
[CUSTOMER][POSITIVE] Correct, it's the extension, correct.
[AGENT][NEUTRAL] Yeah, yeah, there's a simple extraction and then there's the surgical extraction, but that sounds like a surgery extraction. So that one is gonna be also pay at 40%. Um, anything that is major is gonna be paid at 40%. So that one is also 40%. Again, um, the maximum benefit is 1500, OK, per year, per person.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 1500, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, so, so let me ask you one more thing if, if.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] If you go over that 1000.
[AGENT][NEUTRAL] 1500.
[CUSTOMER][NEUTRAL] That means that.
[CUSTOMER][NEUTRAL] Huh?
[AGENT][NEUTRAL] Uh, if you go over the 1500.
[CUSTOMER][NEUTRAL] Statement.
[CUSTOMER][NEUTRAL] In that one year that means if it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I had just come out of pocket with everything.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] That is correct, yes. Your maximum is 1500. After you have used the 1500, we do not pay because that is your maximum per year.
[CUSTOMER][NEGATIVE] Wow. What kind of insurance this is? I don't know. I don't like it. I really don't need it.
[CUSTOMER][POSITIVE] Um, alright, ma'am, you have anything else to say? I'm done, baby. Alright ma'am, I really appreciate everything you do.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] You're welcome, Mr. [PII] [PII]. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] That'll be all.
[AGENT][POSITIVE] OK, thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank