AccountId: 011433970860
ContactId: 5fc86968-6173-4e1c-a80f-e342cdfc5854
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 456290 ms
Total Talk Time (AGENT): 218675 ms
Total Talk Time (CUSTOMER): 152647 ms
Interruptions: 4
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/5fc86968-6173-4e1c-a80f-e342cdfc5854_20250409T20:38_UTC.wav
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[CUSTOMER][NEUTRAL] Um.
[AGENT][POSITIVE] Thank you for calling APL.
[CUSTOMER][NEUTRAL] And that way she got paid for hello.
[AGENT][NEUTRAL] Hello, this is [PII] with APL. How may I help you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, uh, my name is [PII] and I have, um, dental and medical, and, um, I talked to someone just now I might cancel my insurance, but I was calling to find out, um.
[CUSTOMER][NEGATIVE] I, I went to the dentist and had to get extraction, and it was, it didn't cover anything, so I had to pay out of my pocket $432 to get a tooth pulled. I was just calling to find out if there anywhere I could be reimbursed since the insurance did not cover anything.
[AGENT][NEUTRAL] OK, all right, [PII], um, Ms. [PII], I can um check on your policy for you. Can you please give me your policy number?
[CUSTOMER][NEUTRAL] Hold on one minute.
[CUSTOMER][NEUTRAL] It's um
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] 58
[CUSTOMER][NEUTRAL] it's 4702.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] And may I also get your uh callback number, Ms. [PII], just in case our call is disconnected.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. I appreciate that so much. Let me look up your policies real quick.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, Miss [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then also will you please verify your address, phone number and email address for us?
[CUSTOMER][NEUTRAL] [PII] [PII] [PII].
[AGENT][POSITIVE] Thank you. I appreciate it. You verifying your policy for me.
[AGENT][NEUTRAL] Alright, let me look and see now the claim was already sent in by the dental office, is that correct?
[CUSTOMER][NEUTRAL] Yes, it should have. I mean, I was last last month when I went to the dentist. I can't remember the exact date. I mean now on the back of my, off the back of my head, but he.
[AGENT][NEUTRAL] Uh, I see one.
[AGENT][NEUTRAL] Right, I see one from [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Does that sound about right?
[CUSTOMER][NEUTRAL] Yeah, it's the only time I went, yeah. Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, let me look real quick.
[AGENT][NEUTRAL] OK, so it has a remark on the claim, the reason why it wasn't.
[CUSTOMER][NEGATIVE] I have a pain in the.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Servis. Can you hear me?
[CUSTOMER][NEUTRAL] No, you was breaking up. Say that again.
[AGENT][NEUTRAL] Ms. [PII]?
[AGENT][NEUTRAL] I was, I apologize for that. Um, OK, so the claim was sent in and the claim was denied and this is the reason why it was denied. This policy does not provide benefits for any procedure or service not listed in the schedule of covered dental services and procedures. So the reason why it was denied is because it's not covered under your policy.
[CUSTOMER][NEUTRAL] I hear you now.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] A toothful is not covered on on on the policy.
[AGENT][NEUTRAL] No, it's not covered under your policy.
[CUSTOMER][NEUTRAL] So what, what, so, so what, what, what the, what, what would it cover is something what covers does it provide for dentist.
[CUSTOMER][NEUTRAL] What does it provide the dental coverage, so what, what kind of coverage does it provide?
[CUSTOMER][POSITIVE] A cleaner
[AGENT][NEUTRAL] OK, let me check for you real quick. Are you signed up in our online service center?
[CUSTOMER][NEUTRAL] No, I don't, no. Mm mm.
[AGENT][POSITIVE] Let me give you that online service center address so you can sign up for it because you can actually see all of your policies there and you can file claims you can get copies of your cards, it's a really neat thing to have um it's a direct portal to your policy.
[AGENT][NEUTRAL] Let me give you that address. It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Wait, wait, I wait 10. Wait a minute. I had [PII].
[AGENT][NEUTRAL] Oh, I, just let me know, yes, ma'am. Go ahead and let me know when you're ready.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK, so you would go to [PII].
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII] and AM is like [PII].
[CUSTOMER][NEUTRAL] OK, and probably
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]? OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, when you go in there, yeah, when you go in there for the first time you're gonna sign up as a new user, and then that second option is gonna be you're an individual with an APL policy and then you just figure out what you want to use for your username and password and you should be able to get in.
[CUSTOMER][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, and I can do well with that.
[AGENT][NEUTRAL] Right and uh to answer your question about, you should be able to get in there and see your policy, get copies of your cards, file claims on your policies that you have with us.
[CUSTOMER][NEUTRAL] And I can do what
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] You're welcome and your question about why the extraction wasn't covered.
[AGENT][NEUTRAL] When you see your policy.
[AGENT][NEUTRAL] You only have preventative and basic.
[AGENT][NEUTRAL] Um, expenses on this policy.
[CUSTOMER][NEUTRAL] I just, I just, every time, since I've had dental, I just ain't never experienced this having to pay out my pocket for too, a tooth to be pulled.
[AGENT][NEUTRAL] Yes, ma'am. Yes, ma'am. I understand.
[AGENT][NEUTRAL] Right, and you'll see on there.
[CUSTOMER][NEUTRAL] And then didn't covering, cover.
[AGENT][NEUTRAL] Yes, ma'am. You'll see on there that it's preventative and basic expenses.
[CUSTOMER][NEUTRAL] And the medical
[CUSTOMER][NEGATIVE] And, and the uh medical that wouldn't cover my, um my, my medicine for my asthma. That's, so I'm just paying money for 4 months for nothing.
[AGENT][POSITIVE] Oh, I am very sorry to hear that, ma'am. Um, that some of the things that you need covered are not covered under your policies. I apologize for that.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You may, um,
[CUSTOMER][POSITIVE] OK, I appreciate you though.
[AGENT][POSITIVE] Well, we appreciate you and we thank you for being an APL customer and I hope that you have a beautiful day.
[CUSTOMER][NEUTRAL] You do the same.
[AGENT][POSITIVE] All right. You take care. Bye-bye, ma'am.
[CUSTOMER][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] All right, bye-bye.