AccountId: 011433970860
ContactId: 510110dd-8813-44fe-92a6-284d4d822c3b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 370140 ms
Total Talk Time (AGENT): 150467 ms
Total Talk Time (CUSTOMER): 75878 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/510110dd-8813-44fe-92a6-284d4d822c3b_20250325T15:54_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is. How may I help you?
[CUSTOMER][NEGATIVE] Yes, um, I got a call from my dentist. I went up the other day and had my teeth cleaned. Well, they called and said something about, y'all wouldn't, I have insurance with y'all, and they said they wasn't gonna pay or something because of ineligibility. Well, you've played all these years. I don't know what's going on.
[AGENT][POSITIVE] OK, I'm definitely sorry that they um received that message. I'll be more than happy to look into it for you. Um, may I have your name?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And Ms. [PII], may I have a good contact number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] 00.
[CUSTOMER][NEUTRAL] 776-636
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm OK.
[AGENT][NEUTRAL] And I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And Ms. [PII], do you mind if I place you on just a brief hold while I um look into the claim for you or the policy for you?
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Yeah, what happened?
[AGENT][NEUTRAL] I thought that might be the eligibility one.
[AGENT][NEUTRAL] And is it I see.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Hello, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. Um, so I have two options. Looking at everything, it looks like this may be an error because
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] The code that was used is asking about an employer, but your policy isn't on payroll deduction anymore. So I think this may be an error. I'm gonna um send this back to be reprocessed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because that uh.
[AGENT][NEUTRAL] Or
[CUSTOMER][NEUTRAL] Yeah, I wondered why they said ineligible. I thought nothing has changed so I didn't know what they're talking about.
[AGENT][NEUTRAL] So this one, OK, so it's not ineligible in terms of like your policy, that's the wrong code. It's just like sometimes if people work for like temp agencies or something, we have to check and make sure they were on assignment this week or, you know, because it changes. That's what this means.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] Um, but either way, it doesn't apply to you. So I'm gonna, um, well, it's up to you. I can send it back to be reprocessed or if you'd like to hold, I can reach out to claims and see if someone can give me.
[AGENT][NEUTRAL] Um, maybe look into this and give me an answer now, or it's up to you, however you want me to handle it.
[CUSTOMER][NEUTRAL] Mm, I don't know. Um.
[CUSTOMER][NEUTRAL] Send it back in I guess. I don't know which is the best, whichever one you usually do, I guess.
[AGENT][NEUTRAL] Hm, I will go ahead and send the, um, send it back to be reprocess. Let's start there and then they'll look at that code and if it's correct, they'll let us know. If it's not, we can go from there.
[CUSTOMER][POSITIVE] OK. All right. All right, thank you so much. I appreciate it.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, I think you're good.
[AGENT][NEUTRAL] Alright, so usually when we send the request um to be reprocessed, they'll um reach out to us as soon as I get an update, I'll I'll give you a call. Um, it could be someone from claims also sometimes they call and give the updates while they're reprocessing, so you'll definitely hear back from APL. I just don't know if it will be me or claims.
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] OK, all right, perfect. All right, thank you so much.
[AGENT][POSITIVE] You're welcome. Well, thanks for calling APL. You're welcome. I hope you have a great week.
[CUSTOMER][NEUTRAL] OK and you too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.