AccountId: 011433970860
ContactId: 4d648c6f-aef8-4c26-b353-2ca2bd963f35
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 705059 ms
Total Talk Time (AGENT): 358666 ms
Total Talk Time (CUSTOMER): 225430 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/4d648c6f-aef8-4c26-b353-2ca2bd963f35_20250303T15:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling. Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] have to have you give permission every single time.
[CUSTOMER][NEUTRAL] Yes, ma'am. I have a few questions about uh our dental policy and you're probably gonna need my husband's permission to talk to me, so I'll let you talk to him. Hold on just a minute. Hello, ma'am. How are you?
[AGENT][NEUTRAL] OK. Oh, OK.
[AGENT][NEUTRAL] Hi, good. Can I get your name and then your policy number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me get, let me get my glasses on so I can see the policy number.
[AGENT][NEUTRAL] OK. I had to put mine on too this morning.
[CUSTOMER][NEUTRAL] and where they at.
[CUSTOMER][NEUTRAL] They're on the dresser. I see them on the dresser. He let her give you the policy number. I ain't got my glasses. OK.
[AGENT][NEUTRAL] Well, if you could just go ahead and and give us permission to speak with state her name, her uh relationship to you, but I will need you to verify your information [PII] once we pull up the file and then I can speak with your spouse, OK?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, yeah, it's uh uh [PII]. She's my wife.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you give us permission to disclose what type of information to [PII]?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][POSITIVE] Yes. Yes, yes.
[AGENT][NEUTRAL] What what type of information can we disclose? Is she calling for claim status, benefit, or?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Any any information. And ask you if it's just one thing or if you can.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Or what?
[CUSTOMER][NEUTRAL] Are you there?
[AGENT][NEUTRAL] Uh-huh, I'm here.
[CUSTOMER][NEUTRAL] OK. OK, are you ready for the policy number?
[AGENT][NEUTRAL] I am.
[CUSTOMER][NEUTRAL] OK, 02444564.
[AGENT][NEUTRAL] OK, and if you don't mind put [PII] on the phone let me verify his information and then we can connect again, OK, [PII]?
[CUSTOMER][NEUTRAL] That's fine OK I'm here.
[AGENT][NEUTRAL] OK [PII] um verify your uh date of birth, your mailing address, and then the email address on file.
[CUSTOMER][NEUTRAL] OK, uh, date of birth [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, mailing address is [PII].
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Mhm. And your email? Mhm.
[CUSTOMER][NEUTRAL] And my email address is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK thank you and we do have the PO box on file for you thank you so much for verifying.
[CUSTOMER][NEUTRAL] I didn't
[CUSTOMER][NEUTRAL] I didn't know which one, so.
[AGENT][NEUTRAL] Yeah, and what we can do, [PII], we can send an authorization form, uh, that you would need to complete, sign, date and get back to us and that way, giving us telling us you give permission for [PII] to call on your account we could put that in your file and that way when she calls you don't have to verify each time on the phone if you would like to do that.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] That would be perfect, yes ma'am.
[AGENT][NEUTRAL] And is it OK to send it to the email address that you just verified?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so we'll do that before we release the call and I can go ahead and speak with [PII].
[CUSTOMER][NEUTRAL] Right, here she is. Hello.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I was graduation is about the dental plan and the grandson that's on there, [PII].
[AGENT][NEUTRAL] Oh, what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII] check that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what was your question?
[CUSTOMER][NEUTRAL] I need to see if it covers any sort of dental surgery because he's got wisdom teeth coming in.
[AGENT][NEUTRAL] So for wisdom tooth, wisdom tooth removal, that usually, they usually refer you to a surgeon to have the wisdom removed.
[AGENT][NEUTRAL] So although this policy does have major, but if it's for removal of wisdom.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, I think that [PII] may refer him to
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] A surgeon, but let me see what the benefit is for that.
[CUSTOMER][POSITIVE] I appreciate it. Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Of course in any information provided is verification, not a guarantee of payments.
[AGENT][NEUTRAL] So that's gonna be considered a major service.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh, which is reimbursed at 40%.
[AGENT][NEUTRAL] And let me check to see if the wisdom removal is even um included on this plan. I know it's an extraction, but for wisdom it's a little different.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, yeah, yup. It's not so easy.
[AGENT][NEUTRAL] Yeah, let's see.
[CUSTOMER][NEUTRAL] And the dentist will have, well, does he have to, the dentist himself have to send a referral to even get approved for?
[CUSTOMER][NEUTRAL] Uh, an appointment for an oral surgeon.
[AGENT][NEUTRAL] They do they'll have to do yeah they they will mhm they may even, you know, recommend one for you to go to um I don't believe that um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Removal of wisdom teeth is covered. I mean, there are extraction benefits under the policy, um, but I'm not seeing anything that speaks to removal of wisdom.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Teeth.
[CUSTOMER][NEUTRAL] All right, that, that wouldn't be covered then. um.
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And that means that nothing involved would be covered correct like the.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] regarding wisdom removal.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah. OK. OK.
[AGENT][NEUTRAL] Of wisdom teeth.
[CUSTOMER][NEUTRAL] He'd have to talk to someone else about getting, uh, to see if y'all have a plan like that, right?
[AGENT][NEUTRAL] Um, this is a dental policy that's offered by the group.
[CUSTOMER][NEUTRAL] That involves
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Um, and so I don't know if they have any other dental policies that they offer that would be a question that, uh, [PII] would need to ask, uh, his, his employer group or what or UTBA.
[CUSTOMER][NEUTRAL] OK, that's what I was wondering. OK, now, that's all the questions I have at the moment. Let me get you back to him so he can get that permission slip sent over, so yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, um, he's already he's already confirmed that I can send the authorization form to the email address that he verified, but I do wanna send it while I have you on the phone so that you can confirm receipt of it. So give me a quick, quick minute.
[CUSTOMER][POSITIVE] OK, totally.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'll get that over to you.
[CUSTOMER][NEUTRAL] And I might actually have another question too.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Um, can you tell me on the dental providers, all I can find is Boston Mountain, and can you verify that that is all that takes this insurance around here?
[AGENT][NEUTRAL] Give me 1 2nd.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, so I just emailed the
[AGENT][NEUTRAL] Form and.
[AGENT][NEUTRAL] I'm sorry, [PII], can you repeat your question?
[CUSTOMER][NEUTRAL] Yeah, so, yeah, that's OK. Can you verify that uh Boston Mountain Dental is the only place that accepts this insurance?
[AGENT][NEUTRAL] So with this dental policy, it's provider of the patient's choice that they do not have a contracted list of uh providers, dental providers for this plan.
[CUSTOMER][NEUTRAL] What do you mean? I can take them anywhere or?
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Yeah, provider's choice, so you could see anyone, any dental provider. Mhm.
[CUSTOMER][NEUTRAL] A
[CUSTOMER][POSITIVE] OK, OK, awesome. I talked on the Boston Mountain last time and I wasn't real sure about them because that's what all I could find online on the provider information and I thought, well, could, but yeah, that, that's good. I can actually call someone else and see if they'll do it.
[AGENT][NEUTRAL] Yeah. Now, does he have a medical policy?
[CUSTOMER][NEUTRAL] Yeah, yes he did.
[AGENT][NEUTRAL] Because sometimes those items are, you know, they, there may be something under the medical policy that could, uh, cover, not for sure, just depends on what type of policy the removal of the um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, since it's a surgical removal of wisdom.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][POSITIVE] That would be good.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] But all I have right here is the mental set well that thank you for that. I appreciate it. And do I just email this form back or him? He just emails it back to you.
[AGENT][NEUTRAL] Yeah, email it back, but it's coming from [PII], which is me, so don't send it back to me. I'm gonna give you the email address to send it back to let me know when you're ready.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] I am ready.
[AGENT][NEUTRAL] OK, so it's [PII], that's one word, [PII]
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], that[PII] all [PII]. [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII]. That's it it's sent back to you.
[AGENT][POSITIVE] Correct and um.
[AGENT][NEUTRAL] If you open it up, uh, there's one section some people think it's a little confusing that um let me pull that form back up.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Let me see, so.
[AGENT][NEUTRAL] Section C.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] It says the above listed information may be disclosed and used by the following individual organization you would be an individual, so he would put your name there.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Section B.
[AGENT][NEUTRAL] Uh, the purpose of this form is to allow APL or business partners acting on behalf of the APL in the administration of APL products and services to disclose the above named individual, individuals protected health information for the purpose of um.
[AGENT][NEUTRAL] I don't know if you'll be verifying the benefits or checking claim statuses. You may wanna just jot that in there, basically, what information do you are you asking for?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then it says this authorization allows APL to release the type and amount of information as specified below and then it tells you what that is you'll need to tell us what uh claim status benefit information, anything you know and he'll need to complete this just kinda letting you know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] OK, I appreciate it. And as soon as he gets a minute, I got him cooking. I had him take over breakfast. He can then.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh, well, that is too sweet.
[AGENT][NEUTRAL] All right. OK.
[CUSTOMER][POSITIVE] All right. Thank you very much for your help. I appreciate it.
[AGENT][POSITIVE] You're welcome, [PII]. If no other questions, thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.