AccountId: 011433970860
ContactId: 5832ae21-48c1-4635-93e5-6596b3d059da
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 459440 ms
Total Talk Time (AGENT): 122066 ms
Total Talk Time (CUSTOMER): 245348 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/5832ae21-48c1-4635-93e5-6596b3d059da_20250407T13:49_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi [PII]. I'm calling to find out, um, uh, what dentist is, I guess in my network. I, I called the dentist office that I normally go to and they're saying they haven't heard of this insurance.
[CUSTOMER][NEUTRAL] So they advised me to contact you to find out I guess if they're in network.
[CUSTOMER][NEUTRAL] Or if they're out of network, do y'all and I'm sorry she called it something and I just don't know what it I I don't know what it meant and so I don't know what the word was, but something about do y'all cover.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, do you have your policy number handy?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Uh yes, let me get back there to it. It is.
[CUSTOMER][NEUTRAL] OK, I may have to go to the picture. Hold on.
[CUSTOMER][NEUTRAL] It is the policy number is 02566064.
[AGENT][NEUTRAL] OK, could I get your name and date of birth?
[CUSTOMER][NEUTRAL] Uh, my name is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then I just need your address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, it looks like we don't have a PO box on file. Do you have your actual address?
[CUSTOMER][NEUTRAL] Uh, I don't know if you have it. Do you have it at [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, is that correct or do you need to change that?
[CUSTOMER][NEUTRAL] Well we just always prefer to give our PO box, but that is our physical.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's see. OK, so we're checking to see if there's a network. Let me double check that.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Give me just a moment pulling up that information.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so it looks like for your plan, excuse me, um, you do not have a network.
[AGENT][NEUTRAL] So you can see any dentist you like.
[AGENT][NEUTRAL] Um, you'll just present the card to them and then let them know to give us a call and we'll verify what your coverage is.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Oh, OK, because she didn't give me that option.
[AGENT][NEUTRAL] Yeah, so sometimes, sometimes plans do use networks, but this particular plan does not.
[CUSTOMER][NEUTRAL] Huh, OK.
[CUSTOMER][NEUTRAL] OK, so you're saying if I go to any dentist it covers the same regardless whether it's.
[CUSTOMER][NEUTRAL] There's no network is what you're saying.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] Correct. Yes, that's right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, so.
[CUSTOMER][NEUTRAL] Just so I'm uh kind of understanding here like when I go there if they have to do a.
[CUSTOMER][NEUTRAL] Well, let me ask, maybe you have it there because I'm trying to find it here in the paperwork and I maybe I I well here well if it says.
[CUSTOMER][NEUTRAL] Let's see.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] 1st year, 2nd year, 3rd year, so like if, if I wanted to get a um.
[CUSTOMER][NEUTRAL] Oh my lord, what I'm drawing a blank on what it's called.
[CUSTOMER][NEUTRAL] If I wanted to get a uh implant, do you guys cover that?
[AGENT][NEUTRAL] Um, implants.
[AGENT][NEUTRAL] Let's see, those typically are not covered, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Cause he have to do, uh, I know he'll want another root canal, but root canals just don't work for me. I've had so many root canal. I've got teeth missing now because they have went in and redone root canal and eventually just pulled the tube.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And I've got, I've got one room now that was done here in the front and he can't get that too to stay in.
[CUSTOMER][NEGATIVE] And so he talks like when I come back he's gonna have to do something different but he won't tell me what's different and so I'm like, OK, when he says different, does that mean, does that mean implant because I don't know if I'm at the point where I can do partials. I don't know if y'all cover those, but I just know I'm at my wits end and I'm now I'm in pain and he's either gonna have to pull it.
[CUSTOMER][NEUTRAL] Or put something out there that's not a root canal.
[AGENT][NEUTRAL] So it looks like on your policy, and this is not a guarantee of payment, it's a basic outline of your policy, uh, implants are not covered, but I can, um, let me see.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can email you a copy of your breakdown that shows everything that's covered. Do you want me to do that?
[CUSTOMER][NEUTRAL] Now is that the same thing as category of because I'm looking at that but it doesn't really tell me.
[CUSTOMER][NEUTRAL] I mean it says like preventative expenses is 100%.
[CUSTOMER][NEUTRAL] Radio graphs.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, this is
[CUSTOMER][NEUTRAL] Is that what you're wanting to send me?
[AGENT][NEUTRAL] This has a full listing of all of the codes of what's covered.
[AGENT][NEUTRAL] Um, so it includes what you're looking at, but it also includes an additional 1234.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] 7 pages so it'll it'll go into detail of what is covered and what category it's under.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I think that's what I'm looking at. It's just so much there and I'm like, OK, where do I start because I don't wanna have to read 7 pages to get to the root of what I need to find out.
[CUSTOMER][NEUTRAL] Um, because I've got like, well, this one has like 1516 pages.
[CUSTOMER][NEUTRAL] OK, procedure code, is that what you're wanting to send me, preventative expenses.
[AGENT][NEUTRAL] Yeah, so
[AGENT][NEUTRAL] Yeah, it lists it lists the codes and break down under each thing. So if you know, when you go to your consultation, you can talk to them about what the options are and then you can compare it against this um list or again you can call us and we can go through it with you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, right, yeah, I thought that's what.
[CUSTOMER][NEUTRAL] But um let me just try to find a dentist that I don't know, I don't know what to do.
[CUSTOMER][POSITIVE] Alright thank you and that's.
[AGENT][NEUTRAL] OK